Provider Demographics
NPI:1417470816
Name:OMRX,LLC
Entity Type:Organization
Organization Name:OMRX,LLC
Other - Org Name:BREAK FREE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-471-0335
Mailing Address - Street 1:1423 BARLOW CT
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1501
Mailing Address - Country:US
Mailing Address - Phone:847-471-0335
Mailing Address - Fax:
Practice Address - Street 1:4603 OKEECHOBEE BLVD STE 118
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4636
Practice Address - Country:US
Practice Address - Phone:561-268-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS360933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy