Provider Demographics
NPI:1316200686
Name:LOVE RX PHARMACY
Entity type:Organization
Organization Name:LOVE RX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCHAYLITE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SIBLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH
Authorized Official - Phone:214-986-7462
Mailing Address - Street 1:1625 W MOCKINGBIRD LN
Mailing Address - Street 2:STE 206
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-5077
Mailing Address - Country:US
Mailing Address - Phone:214-986-7462
Mailing Address - Fax:
Practice Address - Street 1:1625 W MOCKINGBIRD LN
Practice Address - Street 2:STE 206
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5077
Practice Address - Country:US
Practice Address - Phone:214-986-7462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34293305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization