1255687489 NPI number — RX ADVISORS 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 1255687489 NPI number — RX ADVISORS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RX ADVISORS 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:
1255687489
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2101 HERNDON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLOVIS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93611-6300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-298-0600
Provider Business Mailing Address Fax Number:
559-325-2226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2101 HERNDON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLOVIS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93611-6300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-298-0600
Provider Business Practice Location Address Fax Number:
559-325-2226
Provider Enumeration Date:
07/25/2012

Additional Information

Authorized Official

Authorized Official Last Name:
TA
Authorized Official First Name:
TONY
Authorized Official Middle Name:
MINH
Authorized Official Title or Position:
PIC
Authorized Official Telephone Number:
559-298-0600

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  50969 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHY55976 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; 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" .

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

  • Identifier: 5644441 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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