Provider Demographics
NPI:1285649889
Name:COUNSEL RX INC.
Entity Type:Organization
Organization Name:COUNSEL RX INC.
Other - Org Name:MEDICINE SHOPPE OF BELLEVUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-483-6001
Mailing Address - Street 1:234 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:OH
Mailing Address - Zip Code:44811-1330
Mailing Address - Country:US
Mailing Address - Phone:419-483-6001
Mailing Address - Fax:419-483-3802
Practice Address - Street 1:234 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:OH
Practice Address - Zip Code:44811-1330
Practice Address - Country:US
Practice Address - Phone:419-483-6001
Practice Address - Fax:419-483-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OHPSNH.020721200-033336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0906505Medicaid
2073775OtherPK
OH0567100001Medicare NSC
OHFV96161Medicare PIN