Provider Demographics
NPI:1518083138
Name:ACCUPAX, INC
Entity Type:Organization
Organization Name:ACCUPAX, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTRIEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-287-7345
Mailing Address - Street 1:1385 HELENE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-5405
Mailing Address - Country:US
Mailing Address - Phone:312-287-7345
Mailing Address - Fax:
Practice Address - Street 1:304 W. HIGHWAY 38
Practice Address - Street 2:SUITE 106
Practice Address - City:HARTFORD
Practice Address - State:SD
Practice Address - Zip Code:57033-0397
Practice Address - Country:US
Practice Address - Phone:605-528-2001
Practice Address - Fax:605-528-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD100-18423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy