Provider Demographics
NPI:1093230831
Name:RX HEALTHCARE SYSTEM LLC
Entity Type:Organization
Organization Name:RX HEALTHCARE SYSTEM LLC
Other - Org Name:COMMUNITY PHARMACY OF PORT ORANGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KALPESHKUMAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:321-946-6332
Mailing Address - Street 1:3755 SOUTH NOVA ROAD
Mailing Address - Street 2:UNIT# A
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129
Mailing Address - Country:US
Mailing Address - Phone:321-946-6332
Mailing Address - Fax:
Practice Address - Street 1:3755 S NOVA RD STE A
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-4282
Practice Address - Country:US
Practice Address - Phone:321-946-6332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-12
Last Update Date:2017-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH309033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy