Provider Demographics
NPI:1275288763
Name:DIRECT RX EXCHANGE, LLC
Entity Type:Organization
Organization Name:DIRECT RX EXCHANGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-337-6557
Mailing Address - Street 1:335 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3607
Mailing Address - Country:US
Mailing Address - Phone:847-337-6557
Mailing Address - Fax:
Practice Address - Street 1:335 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-3607
Practice Address - Country:US
Practice Address - Phone:847-337-6557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site