Provider Demographics
NPI:1093057796
Name:COMMUNITY RX PHARMACY, LLC
Entity Type:Organization
Organization Name:COMMUNITY RX PHARMACY, LLC
Other - Org Name:COMMUNITY RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHBUBUR
Authorized Official - Middle Name:RAHMAN
Authorized Official - Last Name:MOTLIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-920-2225
Mailing Address - Street 1:27124 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-3537
Mailing Address - Country:US
Mailing Address - Phone:586-920-2225
Mailing Address - Fax:586-920-2226
Practice Address - Street 1:27124 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3537
Practice Address - Country:US
Practice Address - Phone:586-920-2225
Practice Address - Fax:586-920-2226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy