Provider Demographics
NPI:1710132253
Name:RX CONSULTANTS GROUP INC
Entity Type:Organization
Organization Name:RX CONSULTANTS GROUP INC
Other - Org Name:FIRST STREET MEDICAL PLAZA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:714-309-2068
Mailing Address - Street 1:2010 E 1ST ST
Mailing Address - Street 2:STE 120
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4079
Mailing Address - Country:US
Mailing Address - Phone:714-954-1902
Mailing Address - Fax:714-954-1904
Practice Address - Street 1:2010 E 1ST ST
Practice Address - Street 2:STE 120
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4079
Practice Address - Country:US
Practice Address - Phone:714-954-1902
Practice Address - Fax:714-954-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X, 3336L0003X, 3336S0011X
CAPHY492673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1710132253Medicaid
2117984OtherPK