Provider Demographics
NPI:1922315860
Name:STELLUS RX, LLC
Entity Type:Organization
Organization Name:STELLUS RX, LLC
Other - Org Name:STELLUS RX #1001
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLOUGHBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
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:972-608-2933
Practice Address - Street 1:9990 DALLAS PKWY STE 115
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4135
Practice Address - Country:US
Practice Address - Phone:214-291-5087
Practice Address - Fax:972-608-2933
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATALYST HEALTH GROUP PHARMACY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-13
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 332B00000X, 333600000X, 3336L0003X
TX306843336C0003X
TX274003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157698OtherPK
TX149269Medicaid