Provider Demographics
NPI:1013226687
Name:LIFE SAVERX
Entity Type:Organization
Organization Name:LIFE SAVERX
Other - Org Name:LIFE SAVERX, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CACERES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-283-1131
Mailing Address - Street 1:207 E ROBERTSON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5254
Mailing Address - Country:US
Mailing Address - Phone:813-283-1131
Mailing Address - Fax:813-489-1789
Practice Address - Street 1:207 E ROBERTSON ST STE B
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5254
Practice Address - Country:US
Practice Address - Phone:813-283-1131
Practice Address - Fax:813-489-1789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X, 3336C0004X, 3336I0012X, 3336M0002X, 3336S0011X
FLPH249133336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5702077OtherNCPDP PROVIDER IDENTIFICATION NUMBER