1780671941 NPI number — RXSHOP

Table of content: (NPI 1780671941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780671941 NPI number — RXSHOP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RXSHOP
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:
1780671941
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1571 KY HIGHWAY 259 N
Provider Second Line Business Mailing Address:
PO BOX 540
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42210-9206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-597-2181
Provider Business Mailing Address Fax Number:
270-936-8602

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1571 KY HIGHWAY 259 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42210-9206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-597-2181
Provider Business Practice Location Address Fax Number:
270-936-8602
Provider Enumeration Date:
10/03/2005

Additional Information

Authorized Official

Authorized Official Last Name:
YOUNG
Authorized Official First Name:
RANDALL
Authorized Official Middle Name:
T
Authorized Official Title or Position:
PHARMACY OPERATIONS MANAGER
Authorized Official Telephone Number:
270-597-2181

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  P07732 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1803104 . This is a "NCPDP NUMBER" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com