Active NPI
Axtells Rite Value Pharmacy Inc
- Pharmacist
- Whitesboro, TX
National Provider Identifier
1972553915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36160
- Legal business name
- AXTELLS RITE VALUE PHARMACY INC
- Practice address
- 304 1/2 Charlie Dr.
Whitesboro, TX 76273 - Phone
- (903) 564-3216
- Fax
- (903) 564-3792
- NPI assigned
- May 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Tom Axtell Jr., RPH.
- Title
- Owner
- Phone
- (903) 564-3216
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36160 | TX | Primary |
Addresses
Primary practice location
304 1/2 Charlie Dr.
Whitesboro, TX 76273
Mailing address
PO Box 9
Whitesboro, TX 76273-0009
Phone (903) 564-3216
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144814 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140228000895 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 0345455374 | Practice locations: Whitesboro, TX |
National Provider Directory
National Provider DirectoryLocations
304 Charlie Dr
Whitesboro, TX 76273
Phone (903) 564-3216
304 1/2 Charlie Dr
Whitesboro, TX 76273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1660780800000",
"number": "1972553915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9",
"city": "WHITESBORO",
"state": "TX",
"postal_code": "762730009",
"telephone_number": "903-564-3216",
"fax_number": "903-564-7261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 1/2 CHARLIE DR.",
"city": "WHITESBORO",
"state": "TX",
"postal_code": "76273",
"telephone_number": "903-564-3216",
"fax_number": "903-564-3792"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AXTELLS RITE VALUE PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-11",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A",
"authorized_official_last_name": "AXTELL",
"authorized_official_first_name": "TOM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "903-564-3216",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "RPH."
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "TX",
"license": "36160",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144814",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Whitesboro, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.