Provider Demographics
NPI:1467822981
Name:RX MART LLC
Entity Type:Organization
Organization Name:RX MART LLC
Other - Org Name:SAFECARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-325-6047
Mailing Address - Street 1:1785 NONCONNAH BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38132-2104
Mailing Address - Country:US
Mailing Address - Phone:901-730-7769
Mailing Address - Fax:888-684-0242
Practice Address - Street 1:10995 PLANO RD STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5321
Practice Address - Country:US
Practice Address - Phone:972-525-2226
Practice Address - Fax:972-270-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-26
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX303323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2155430OtherPK