Provider Demographics
NPI:1043221625
Name:UNITED RX LLC
Entity Type:Organization
Organization Name:UNITED RX LLC
Other - Org Name:PNS-PHARMACY NETWORK SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BENAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:708-449-7600
Mailing Address - Street 1:150 FENCL LANE
Mailing Address - Street 2:ATTN: HENRY HERNADEZ
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162
Mailing Address - Country:US
Mailing Address - Phone:708-449-7600
Mailing Address - Fax:855-422-0782
Practice Address - Street 1:527 N. STATE OF FRANKLIN RD.
Practice Address - Street 2:SUITE 1
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8210
Practice Address - Country:US
Practice Address - Phone:423-926-3338
Practice Address - Fax:423-926-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3121333600000X
VA02140011043336L0003X
NC120813336L0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3010035Medicaid
2091763OtherPK
TN320218822Medicaid