Provider Demographics
NPI:1700322641
Name:MARGO RX LLC
Entity Type:Organization
Organization Name:MARGO RX LLC
Other - Org Name:RICHARD'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-464-4131
Mailing Address - Street 1:605 N MAIN ST STE E
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-2726
Mailing Address - Country:US
Mailing Address - Phone:956-464-4131
Mailing Address - Fax:956-464-4181
Practice Address - Street 1:605 N MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-2726
Practice Address - Country:US
Practice Address - Phone:956-464-4131
Practice Address - Fax:956-464-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX311443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149559Medicaid
2166234OtherPK