Provider Demographics
NPI:1619375961
Name:A-CLASS PHARMACY LLC
Entity Type:Organization
Organization Name:A-CLASS PHARMACY LLC
Other - Org Name:A-CLASS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,AO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FERIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-501-0453
Mailing Address - Street 1:807 N CAGE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-3117
Mailing Address - Country:US
Mailing Address - Phone:817-466-7420
Mailing Address - Fax:817-382-5164
Practice Address - Street 1:807 N CAGE BLVD STE B
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-3117
Practice Address - Country:US
Practice Address - Phone:817-466-7420
Practice Address - Fax:817-382-5164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX300643336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149262Medicaid
2152923OtherPK