Provider Demographics
NPI:1528074168
Name:RX FULFILLMENT SERVICES
Entity type:Organization
Organization Name:RX FULFILLMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-278-1987
Mailing Address - Street 1:PO BOX 571855
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77257-1855
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 WILCREST DR
Practice Address - Street 2:STE 580
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-6030
Practice Address - Country:US
Practice Address - Phone:281-583-2223
Practice Address - Fax:281-583-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 3336M0002X, 3336C0004X
TX25423333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Not Answered3336M0002XSuppliersPharmacyMail Order Pharmacy
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4512580OtherOTHER ID NUMBER-COMMERCIAL NUMBER
TX145443Medicaid