Provider Demographics
NPI:1932560182
Name:AAA RX PHARMACY LLC
Entity Type:Organization
Organization Name:AAA RX PHARMACY LLC
Other - Org Name:AAA RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-717-8877
Mailing Address - Street 1:6725 S FRY RD STE 700-532
Mailing Address - Street 2:STE 700-532
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8102
Mailing Address - Country:US
Mailing Address - Phone:281-717-8877
Mailing Address - Fax:281-717-8847
Practice Address - Street 1:569 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2437
Practice Address - Country:US
Practice Address - Phone:281-717-8877
Practice Address - Fax:281-717-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX310893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166094OtherPK