Provider Demographics
NPI:1386187474
Name:PATIENT DIRECT RX
Entity Type:Organization
Organization Name:PATIENT DIRECT RX
Other - Org Name:PATIENT DIRECT RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BORELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-567-1642
Mailing Address - Street 1:301 OXFORD VALLEY ROAD, SUITE 1203A
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:866-567-1642
Mailing Address - Fax:215-323-4106
Practice Address - Street 1:301 OXFORD VALLEY ROAD, SUITE 1203A
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:866-567-1642
Practice Address - Fax:215-323-4106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP4821733336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166339OtherPK