Provider Demographics
NPI:1477647782
Name:SMRX INC
Entity Type:Organization
Organization Name:SMRX INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:915-544-6605
Mailing Address - Street 1:2002 GRANT AVE
Mailing Address - Street 2:STE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-1017
Mailing Address - Country:US
Mailing Address - Phone:915-544-6605
Mailing Address - Fax:915-532-6973
Practice Address - Street 1:2002 GRANT AVE
Practice Address - Street 2:STE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-1017
Practice Address - Country:US
Practice Address - Phone:915-544-6605
Practice Address - Fax:915-532-6973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20610333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4583135OtherOTHER ID NUMBER-COMMERCIAL NUMBER
TX145021Medicaid
TX145021Medicaid