Provider Demographics
NPI:1164841987
Name:RXPRESS PHARMACY LLC
Entity Type:Organization
Organization Name:RXPRESS PHARMACY LLC
Other - Org Name:RXPRESS PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANGOO-DOOKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-593-4038
Mailing Address - Street 1:7970 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4712
Mailing Address - Country:US
Mailing Address - Phone:954-227-3042
Mailing Address - Fax:954-227-3043
Practice Address - Street 1:7970 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33065-4712
Practice Address - Country:US
Practice Address - Phone:954-227-3042
Practice Address - Fax:954-227-3043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
FLPH279383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145140OtherPK