Provider Demographics
NPI:1154300267
Name:RX SPECIALITIES NH INC
Entity Type:Organization
Organization Name:RX SPECIALITIES NH INC
Other - Org Name:RX SPECIALITIES NH INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-965-9252
Mailing Address - Street 1:6443 INKSTER RD
Mailing Address - Street 2:STE 170
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-1318
Mailing Address - Country:US
Mailing Address - Phone:248-546-5500
Mailing Address - Fax:
Practice Address - Street 1:23751 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-2817
Practice Address - Country:US
Practice Address - Phone:248-546-5500
Practice Address - Fax:248-546-8979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
MI53010066773336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2044069OtherPK
MI4857767Medicaid
2044069OtherPK