Provider Demographics
NPI:1770881799
Name:PHARMACY EXPRESS LLC
Entity type:Organization
Organization Name:PHARMACY EXPRESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:YIXIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-515-2808
Mailing Address - Street 1:8801 N 10TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9515
Mailing Address - Country:US
Mailing Address - Phone:956-515-2808
Mailing Address - Fax:214-388-7392
Practice Address - Street 1:8801 N 10TH ST STE 130
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-9515
Practice Address - Country:US
Practice Address - Phone:956-515-2808
Practice Address - Fax:214-388-7392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149832Medicaid