Organization
RX SOS PLLC
Active
Other names
Grapevine Drug RX
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY MOSS (PRESIDENT)
(817) 481-5780
Entity
Organization
Contact information
Practice address
1115 W NORTHWEST HWY STE H, GRAPEVINE, TX 76051-5010
(817) 481-5780
(817) 442-0435
Mailing address
1115 W NORTHWEST HWY STE H, GRAPEVINE, TX 76051-5010
(817) 481-5780
(817) 442-0435
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30574
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149493
—
TX
01
—
2160256
PK
—
Enumeration date
05/11/2016
Last updated
03/01/2017
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