Provider Demographics
NPI:1710633037
Name:PROHEALTH RX LLC
Entity Type:Organization
Organization Name:PROHEALTH RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:UDAY
Authorized Official - Middle Name:NARAYAN
Authorized Official - Last Name:MISHRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-816-5955
Mailing Address - Street 1:1061 MCCOY DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7103
Mailing Address - Country:US
Mailing Address - Phone:614-845-5151
Mailing Address - Fax:614-845-5152
Practice Address - Street 1:958 N WAGGONER RD
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7911
Practice Address - Country:US
Practice Address - Phone:614-369-6539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy