Provider Demographics
NPI:1740845874
Name:LONG MEADOW RX, LLC
Entity type:Organization
Organization Name:LONG MEADOW RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-945-2480
Mailing Address - Street 1:5530 LONG PRAIRIE TRCE STE 500
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2334
Mailing Address - Country:US
Mailing Address - Phone:832-945-2480
Mailing Address - Fax:
Practice Address - Street 1:5530 LONG PRAIRIE TRCE STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-2331
Practice Address - Country:US
Practice Address - Phone:281-325-8099
Practice Address - Fax:888-207-3432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy