Provider Demographics
NPI:1376945493
Name:RX EXPRESS PHARMACY INC.
Entity Type:Organization
Organization Name:RX EXPRESS PHARMACY INC.
Other - Org Name:RX EXPRESS PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:732-851-7272
Mailing Address - Street 1:356 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8262
Mailing Address - Country:US
Mailing Address - Phone:732-851-7272
Mailing Address - Fax:732-851-7271
Practice Address - Street 1:356 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8262
Practice Address - Country:US
Practice Address - Phone:732-851-7272
Practice Address - Fax:732-851-7271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-19
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007355003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0448958Medicaid
2148342OtherPK
NJ0500704Medicaid
2148342OtherPK