Provider Demographics
NPI:1649885195
Name:ROCKET PHARMACY, INC.
Entity type:Organization
Organization Name:ROCKET PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-983-8186
Mailing Address - Street 1:316 W 12TH ST STE LL050
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1815
Mailing Address - Country:US
Mailing Address - Phone:888-900-7361
Mailing Address - Fax:888-900-7361
Practice Address - Street 1:316 W 12TH ST STE LL050
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1815
Practice Address - Country:US
Practice Address - Phone:888-900-7361
Practice Address - Fax:888-900-7361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33403OtherTEXAS STATE BOARD OF PHARMACY