Provider Demographics
NPI:1881208288
Name:OCEAN BLUE HOLDINGS, LLC
Entity Type:Organization
Organization Name:OCEAN BLUE HOLDINGS, LLC
Other - Org Name:TEXAS HEALTH RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-873-3826
Mailing Address - Street 1:12333 BEAR PLZ STE 100
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0284
Mailing Address - Country:US
Mailing Address - Phone:817-789-4099
Mailing Address - Fax:
Practice Address - Street 1:12333 BEAR PLZ STE 100
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0284
Practice Address - Country:US
Practice Address - Phone:817-789-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150249Medicaid