1568179489 NPI number — CARELONRX PHARMACY INC.

Table of content: (NPI 1568179489)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568179489 NPI number — CARELONRX PHARMACY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARELONRX PHARMACY 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:
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:
1568179489
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
450 HEADQUARTERS PLAZA
Provider Second Line Business Mailing Address:
SUITE 710, EAST TOWER, 7TH FLOOR
Provider Business Mailing Address City Name:
MORRISTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07960
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:
4821 N STONE AVE STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85704-5727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-947-3784
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2022

Additional Information

Authorized Official

Authorized Official Last Name:
EDWARDS
Authorized Official First Name:
CLAYTON
Authorized Official Middle Name:
D
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
772-631-7376

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; 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: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com