1306213384 NPI number — NOWRX INC

Table of content: (NPI 1306213384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306213384 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:
1306213384
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 HILL
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:
1050 INDEPENDENCE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTAIN VIEW
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94043-1610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-386-5761
Provider Business Practice Location Address Fax Number:
650-963-3204
Provider Enumeration Date:
08/26/2015

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: 3336C0003X , with the licence number: PHY53836 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2153578 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5656559 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100130425 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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