Provider Demographics
NPI:1275562324
Name:RX, INC
Entity Type:Organization
Organization Name:RX, INC
Other - Org Name:MEDICAP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FREUND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-760-0200
Mailing Address - Street 1:800 VALLEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-1969
Mailing Address - Country:US
Mailing Address - Phone:573-760-0200
Mailing Address - Fax:573-760-8777
Practice Address - Street 1:800 VALLEY CREEK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1969
Practice Address - Country:US
Practice Address - Phone:573-760-0200
Practice Address - Fax:573-760-8777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332B00000X
MO0401573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO608084109Medicaid
MO2630196OtherNCPDP #
MOBR4648335OtherDEA #
MOBR4648335OtherDEA #
MO1038210001Medicare NSC