Provider Demographics
NPI:1225520653
Name:JLGRX LLC
Entity Type:Organization
Organization Name:JLGRX LLC
Other - Org Name:RX REMEDI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-321-3711
Mailing Address - Street 1:50 THREE TUN RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3988
Mailing Address - Country:US
Mailing Address - Phone:484-321-3711
Mailing Address - Fax:484-321-3710
Practice Address - Street 1:50 THREE TUN RD STE 2
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3988
Practice Address - Country:US
Practice Address - Phone:484-321-3711
Practice Address - Fax:484-321-3710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336S0011X
PAPP4827903336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177903OtherPK