Provider Demographics
NPI:1518580422
Name:MEDSTORK RX, LLC
Entity Type:Organization
Organization Name:MEDSTORK RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-689-9442
Mailing Address - Street 1:156 FALCON POINT DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-8652
Mailing Address - Country:US
Mailing Address - Phone:972-689-9442
Mailing Address - Fax:
Practice Address - Street 1:1413 E INTERSTATE 30 STE 6
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-4784
Practice Address - Country:US
Practice Address - Phone:888-700-5702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy