Provider Demographics
NPI:1699215160
Name:UPLIFT RX, LLC
Entity Type:Organization
Organization Name:UPLIFT RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEEBA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-815-2352
Mailing Address - Street 1:15462 FM 529 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2702
Mailing Address - Country:US
Mailing Address - Phone:281-815-2352
Mailing Address - Fax:
Practice Address - Street 1:15462 FM 529 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2702
Practice Address - Country:US
Practice Address - Phone:281-815-2352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX312913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy