Provider Demographics
NPI:1568517613
Name:PHYSICIAN RX MGMT INC.
Entity Type:Organization
Organization Name:PHYSICIAN RX MGMT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-471-3578
Mailing Address - Street 1:31500 GRAPE ST # 3-120
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-9702
Mailing Address - Country:US
Mailing Address - Phone:951-471-3578
Mailing Address - Fax:951-245-4725
Practice Address - Street 1:611 W GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-3516
Practice Address - Country:US
Practice Address - Phone:951-471-3578
Practice Address - Fax:951-245-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2621975171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty