Provider Demographics
NPI:1629651443
Name:SH RXM JV, LLC
Entity Type:Organization
Organization Name:SH RXM JV, LLC
Other - Org Name:CATALYST HEALTH RX 1002
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLOUGHBY
Authorized Official - Suffix:
Authorized Official - Credentials:DPH
Authorized Official - Phone:214-291-5087
Mailing Address - Street 1:8277 BELLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0358
Mailing Address - Country:US
Mailing Address - Phone:214-291-5087
Mailing Address - Fax:
Practice Address - Street 1:855 MONTGOMERY ST STE 150
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2553
Practice Address - Country:US
Practice Address - Phone:214-291-5087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIAN INNOVATION COMPANY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-29
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy