Provider Demographics
NPI:1891284451
Name:RXPRO MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:RXPRO MEDICAL SUPPLY, LLC
Other - Org Name:RXPRO MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:AMORIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA
Authorized Official - Phone:972-954-9400
Mailing Address - Street 1:1105 E MAIN ST # 228
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3909
Mailing Address - Country:US
Mailing Address - Phone:972-954-9400
Mailing Address - Fax:214-785-4594
Practice Address - Street 1:1719 ANGEL PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-2697
Practice Address - Country:US
Practice Address - Phone:972-954-9400
Practice Address - Fax:972-433-9243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1003082OtherTX DSHS LICENSE
5925055OtherNCPDP