Provider Demographics
NPI:1497842306
Name:RX SOUTH LLC
Entity Type:Organization
Organization Name:RX SOUTH LLC
Other - Org Name:RX3 COMPOUNDING PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:804-717-5000
Mailing Address - Street 1:12230 IRON BRIDGE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1534
Mailing Address - Country:US
Mailing Address - Phone:804-717-5000
Mailing Address - Fax:804-717-8300
Practice Address - Street 1:12230 IRON BRIDGE RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1534
Practice Address - Country:US
Practice Address - Phone:804-717-5000
Practice Address - Fax:804-717-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336C0004X, 3336I0012X, 3336S0011X
VA02010036853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2104774OtherPK
VA8508178Medicaid