Provider Demographics
NPI:1013576693
Name:RX CLINIC PHARMACY, LLC
Entity Type:Organization
Organization Name:RX CLINIC PHARMACY, LLC
Other - Org Name:AVANT PHARMACY AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUBAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:215-840-5510
Mailing Address - Street 1:10508 PARK RD STE 130
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8526
Mailing Address - Country:US
Mailing Address - Phone:704-519-2800
Mailing Address - Fax:704-519-2801
Practice Address - Street 1:10508 PARK RD STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8526
Practice Address - Country:US
Practice Address - Phone:704-519-2800
Practice Address - Fax:704-519-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-07
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy