Provider Demographics
NPI:1619988516
Name:RUMSEY PHARMACY INC.
Entity Type:Organization
Organization Name:RUMSEY PHARMACY INC.
Other - Org Name:ELAM ROAD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:RUMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:214-391-6363
Mailing Address - Street 1:9209 ELAM RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-4179
Mailing Address - Country:US
Mailing Address - Phone:214-391-6363
Mailing Address - Fax:214-391-6004
Practice Address - Street 1:9209 ELAM RD
Practice Address - Street 2:SUITE 105
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4179
Practice Address - Country:US
Practice Address - Phone:214-391-6363
Practice Address - Fax:214-391-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186133336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
BE5575343OtherUS DEPT OF JUSTICE
TX144661Medicaid
TX18613OtherTX BOARD OF PHARMACY
TXP0104591OtherTX DEPT OF PUBLIC SAFETY