Provider Demographics
NPI:1386659910
Name:WORLD RX INC
Entity Type:Organization
Organization Name:WORLD RX INC
Other - Org Name:DEL REY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-344-3462
Mailing Address - Street 1:8131 W MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-8211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8131 W MANCHESTER AVE
Practice Address - Street 2:
Practice Address - City:PLAYA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90293-8211
Practice Address - Country:US
Practice Address - Phone:310-823-9242
Practice Address - Fax:310-821-5795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY471313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0506254OtherOTHER ID NUMBER-COMMERCIAL NUMBER
CAPHA451370Medicaid
4771760002Medicare ID - Type Unspecified