Provider Demographics
NPI:1740731603
Name:RSVP PHARMACY NO 1 LLC
Entity type:Organization
Organization Name:RSVP PHARMACY NO 1 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY LICENSING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-316-5090
Mailing Address - Street 1:6300 BRIDGE POINT PKWY
Mailing Address - Street 2:BLDG 3 STE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-5073
Mailing Address - Country:US
Mailing Address - Phone:512-279-4501
Mailing Address - Fax:
Practice Address - Street 1:1700 ROYSTON LN STE B
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-9501
Practice Address - Country:US
Practice Address - Phone:877-316-5090
Practice Address - Fax:877-335-7994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
TX310473336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2164674OtherPK