Provider Demographics
NPI:1649367848
Name:RWO LP
Entity type:Organization
Organization Name:RWO LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:806-293-2689
Mailing Address - Street 1:3322 OLTON RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-6630
Mailing Address - Country:US
Mailing Address - Phone:806-293-2689
Mailing Address - Fax:806-296-0199
Practice Address - Street 1:3322 OLTON RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-6630
Practice Address - Country:US
Practice Address - Phone:806-293-2689
Practice Address - Fax:806-296-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX275873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4594291OtherNCPDP PROVIDER IDENTIFICATION NUMBER