1578142303 NPI number — NOWRX INC

Table of content: DR. NICHOLAS PERTUIT PHD, MS (NPI 1942025176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578142303 NPI number — NOWRX INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOWRX INC
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:
6
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:
1578142303
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30025 ALICIA PARKWAY, SUITE 674
Provider Second Line Business Mailing Address:
ATTENTION: COMPLIANCE
Provider Business Mailing Address City Name:
LAGUNA HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92677-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-449-2700
Provider Business Mailing Address Fax Number:
949-606-9212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26081 MERIT CIR STE 116
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAGUNA HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92653-7017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-449-2700
Provider Business Practice Location Address Fax Number:
650-729-0927
Provider Enumeration Date:
04/07/2021

Additional Information

Authorized Official

Authorized Official Last Name:
HANCOCK
Authorized Official First Name:
CHRISTIE
Authorized Official Middle Name:
Authorized Official Title or Position:
COMPLIANCE MANAGER
Authorized Official Telephone Number:
407-777-7435

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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