1225548480 NPI number — STERLINGRX INC

Table of content: (NPI 1225548480)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225548480 NPI number — STERLINGRX INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STERLINGRX 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:
1225548480
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1312 NORTHLAND DR
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
MENDOTA HEIGHTS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55120-1140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-618-4126
Provider Business Mailing Address Fax Number:
866-588-0371

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1312 NORTHLAND DR
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
MENDOTA HEIGHTS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55120-1140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-618-4126
Provider Business Practice Location Address Fax Number:
866-588-0371
Provider Enumeration Date:
10/02/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SELLNER
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
DIRECTOR OF PHARMACY
Authorized Official Telephone Number:
612-840-3720

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  4912 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 64002523A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 054.020835 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 2018016399 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PH00004634 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 48036MS , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 400-1782 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 036543 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHAR1471 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 265419 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: NR1584 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 1169 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHNR.FO.60839575 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 022884200 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: Y007446 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1225548480 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1225548480 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1225548480 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2171888 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10026690200 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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