Provider Demographics
NPI:1497102479
Name:PREFERRED RX DIRECT LLC
Entity Type:Organization
Organization Name:PREFERRED RX DIRECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPED
Authorized Official - Phone:903-680-3113
Mailing Address - Street 1:8476 ARROWWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BIG SANDY
Mailing Address - State:TX
Mailing Address - Zip Code:75755-3506
Mailing Address - Country:US
Mailing Address - Phone:903-725-7634
Mailing Address - Fax:903-680-5131
Practice Address - Street 1:8476 ARROWWOOD RD
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:TX
Practice Address - Zip Code:75755-3506
Practice Address - Country:US
Practice Address - Phone:903-725-7634
Practice Address - Fax:903-680-5131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy