Provider Demographics
NPI:1093134736
Name:COMMUNITY CARE RX LLC
Entity Type:Organization
Organization Name:COMMUNITY CARE RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-722-3400
Mailing Address - Street 1:725A LONG LN
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-5323
Mailing Address - Country:US
Mailing Address - Phone:215-722-3400
Mailing Address - Fax:215-722-3401
Practice Address - Street 1:725A LONG LN
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-5323
Practice Address - Country:US
Practice Address - Phone:215-722-3400
Practice Address - Fax:215-722-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy