Organization
RIVERS STATE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XENIA MARTINEZ (OWNER/DIRECTOR)
(832) 363-3179
Entity
Organization
Contact information
Practice address
1919 AVENUE H STE 100, ROSENBERG, TX 77471-2629
(832) 363-3179
(832) 363-3634
Mailing address
1919 AVENUE H STE 100, ROSENBERG, TX 77471-2629
(832) 363-3179
(832) 363-3634
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01
COMMERCIAL INSURANCE
—
Enumeration date
01/21/2020
Last updated
12/07/2020
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