Provider Demographics
NPI:1083495139
Name:CATALYST RX PHARMACY LLC
Entity Type:Organization
Organization Name:CATALYST RX PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIRALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALWANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:785-979-8677
Mailing Address - Street 1:558 OLD NORCROSS RD STE 207
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4385
Mailing Address - Country:US
Mailing Address - Phone:785-979-8677
Mailing Address - Fax:
Practice Address - Street 1:558 OLD NORCROSS RD STE 207
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4385
Practice Address - Country:US
Practice Address - Phone:785-979-8677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy