1487118717 NPI number — LITON 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 1487118717 NPI number — LITON RX, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITON 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:
1487118717
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2080 N DOBSON RD STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85224-2391
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-855-7706
Provider Business Mailing Address Fax Number:
623-209-8286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2080 N. DOBSON ROAD
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-304-2221
Provider Business Practice Location Address Fax Number:
888-239-8423
Provider Enumeration Date:
01/31/2019

Additional Information

Authorized Official

Authorized Official Last Name:
WHALEN
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
DIRECTOR OF PHARMACY OPERATIONS
Authorized Official Telephone Number:
480-855-7706

Provider Taxonomy Codes

  • 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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