Riftco Innovations, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

31276 Issued in TX

Legal business name

RIFTCO INNOVATIONS, LLC

Doing business as

Katy Memorial Pharmacy

Practice address

23920 Katy Fwy
Suite 112
Katy, TX 77494-1341

Phone

(832) 437-7864

Fax

(832) 437-7875

NPI assigned

Feb 16, 2017

Last updated

Feb 17, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Idris B Mansuri, RPH

Title

Pharmacy Manager

Phone

(713) 557-6499

Specialties & licenses 1

Addresses

Other names 1

• Katy Memorial Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1528507092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23920 KATY FWY",
            "address_2": "SUITE 112",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941341",
            "telephone_number": "832-437-7864",
            "fax_number": "832-437-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23920 KATY FWY",
            "address_2": "SUITE 112",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774941341",
            "telephone_number": "832-437-7864",
            "fax_number": "832-437-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIFTCO INNOVATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-16",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "MANSURI",
        "authorized_official_first_name": "IDRIS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "713-557-6499",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "31276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Katy Memorial Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Madeline Lea Rickmers, LMFT-A
• Jared Ricks, DDS
• Meredith Riddick, LPC-S, CEDS-S
• Aryn Rieder, M.S., CCC-SLP
• Pedro Javier Riera, C-SA
• Brian Mark Riggs, DC
• Pardeep Singh Rihal, M.D.
• Bernadette Riley
• Julie Riley, LPC, ATR
• Vincent J Rillo, PTA

• Community/Retail Pharmacy in Katy, TX
• Providers in Katy, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.