Provider Demographics
NPI:1407369929
Name:RX PHARMACEUTICAL, INC
Entity Type:Organization
Organization Name:RX PHARMACEUTICAL, INC
Other - Org Name:TARZANA WELLNESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:THAO
Authorized Official - Middle Name:PHUONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-600-8800
Mailing Address - Street 1:18406 GRESHAM ST APT 103
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-3074
Mailing Address - Country:US
Mailing Address - Phone:818-256-7777
Mailing Address - Fax:
Practice Address - Street 1:18840 VENTURA BLVD STE 120
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3301
Practice Address - Country:US
Practice Address - Phone:818-600-8800
Practice Address - Fax:866-394-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy