Organization
SULLIVAN S DRUG LLC
Active
Organization
SULLIVAN S DRUG LLC
Active
Other names
Sullivan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODOLFO RANGEL (OWNER/PHARMACIST)
(956) 793-3738
Entity
Organization
Contact information
Practice address
1140 GRAND AVE, BACLIFF, TX 77518-2760
(281) 339-4577
(281) 559-4339
Mailing address
1140 GRAND AVE, BACLIFF, TX 77518-2760
(281) 339-4577
(281) 559-4339
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
13309
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150045
—
TX
01
—
4577219
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/10/2006
Last updated
07/27/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up