Provider Demographics
NPI:1346907003
Name:MEDRX PHARMA INC
Entity Type:Organization
Organization Name:MEDRX PHARMA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:PHOEBE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-533-0212
Mailing Address - Street 1:1556 N D ST STE B
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4710
Mailing Address - Country:US
Mailing Address - Phone:909-533-0212
Mailing Address - Fax:
Practice Address - Street 1:1556 N D ST STE B
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4710
Practice Address - Country:US
Practice Address - Phone:909-533-0212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy