Provider Demographics
NPI:1497347462
Name:ATLAS RX LLC
Entity Type:Organization
Organization Name:ATLAS RX LLC
Other - Org Name:ATLAS RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:708-728-5052
Mailing Address - Street 1:11923 PACIFIC ST STE A
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3468
Mailing Address - Country:US
Mailing Address - Phone:402-520-6601
Mailing Address - Fax:402-520-6622
Practice Address - Street 1:11923 PACIFIC ST STE A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3468
Practice Address - Country:US
Practice Address - Phone:402-520-6601
Practice Address - Fax:402-520-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy