Provider Demographics
NPI:1598188427
Name:NEXTRX PHARMA LLC
Entity Type:Organization
Organization Name:NEXTRX PHARMA LLC
Other - Org Name:NEXTRX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSSEIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-763-9879
Mailing Address - Street 1:38900 TRADE CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3715
Mailing Address - Country:US
Mailing Address - Phone:844-763-9879
Mailing Address - Fax:844-763-2776
Practice Address - Street 1:38900 TRADE CENTER DR STE A
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3715
Practice Address - Country:US
Practice Address - Phone:844-763-9879
Practice Address - Fax:844-763-2776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA558953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2144004OtherPK
CA1598188427Medicaid