1205043312 NPI number — CENTRAL RX INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205043312 NPI number — CENTRAL RX INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL RX 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:
1205043312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11536
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST THOMAS
Provider Business Mailing Address State Name:
VI
Provider Business Mailing Address Postal Code:
00801-4536
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:
7 CHARLOTTE AMALIE
Provider Second Line Business Practice Location Address:
TIME CENTER BUILDING
Provider Business Practice Location Address City Name:
ST THOMAS
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-774-4033
Provider Business Practice Location Address Fax Number:
340-777-5478
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BENJAMIN
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANG
Authorized Official Telephone Number:
340-775-0484

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  130481L , registered in the state of VI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2112051 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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