Organization
PRIMESOURCE RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TRUONG (SENIOR VICE PRESIDENT)
(832) 464-7616
Entity
Organization
Contact information
Practice address
2656 S LOOP W STE 574, HOUSTON, TX 77054-2664
(832) 464-7616
Mailing address
2656 S LOOP W STE 574, HOUSTON, TX 77054-2664
(832) 464-7616
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Enumeration date
01/05/2016
Last updated
10/07/2019
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