1144563768 NPI number — RXALLY ADMINISTRATIVE SERVICES

Table of content: (NPI 1144563768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144563768 NPI number — RXALLY ADMINISTRATIVE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RXALLY ADMINISTRATIVE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144563768
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 LOUDOUN ST SE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LEESBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20175-3117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 HARRISON ST SE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20175-3729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-621-2208
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEVINE
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
703-621-0556

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  0201004508 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)