Provider Demographics
NPI:1508919416
Name:RXPERT INC
Entity Type:Organization
Organization Name:RXPERT INC
Other - Org Name:COMPOUNDING SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAGE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:515-432-1643
Mailing Address - Street 1:102 S STORY ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036
Mailing Address - Country:US
Mailing Address - Phone:515-432-1643
Mailing Address - Fax:515-433-2055
Practice Address - Street 1:102 S STORY ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036
Practice Address - Country:US
Practice Address - Phone:515-432-1643
Practice Address - Fax:515-433-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA10663336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1619660OtherNCPDP