Provider Demographics
NPI:1427690577
Name:BIRCHWOOD RX
Entity type:Organization
Organization Name:BIRCHWOOD RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSANA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-707-9575
Mailing Address - Street 1:2506 OVILLA RD STE A
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-4008
Mailing Address - Country:US
Mailing Address - Phone:469-820-9722
Mailing Address - Fax:469-820-9723
Practice Address - Street 1:2506 OVILLA RD STE A
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-4008
Practice Address - Country:US
Practice Address - Phone:469-820-9722
Practice Address - Fax:469-820-9723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy