Organization Active NPI

Axtells Rite Value Pharmacy Inc

  • Pharmacist
  • Whitesboro, TX
National Provider Identifier
1972553915
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
36160 Issued in TX
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

Updated by the provider on Aug 18, 2022

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)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
144814MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140228000895 TX Part B Supplier - Mass Immunization (Roster Biller Only) 0345455374 Practice locations: Whitesboro, TX

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.