Provider Demographics
NPI:1710750997
Name:3D RX, INC
Entity Type:Organization
Organization Name:3D RX, INC
Other - Org Name:STOCKMEN'S DRUG CRAWFORD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:IANNIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:833-457-0971
Mailing Address - Street 1:116 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:NE
Mailing Address - Zip Code:69343-1524
Mailing Address - Country:US
Mailing Address - Phone:833-457-0971
Mailing Address - Fax:
Practice Address - Street 1:202 MAIN ST
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:NE
Practice Address - Zip Code:69339-1026
Practice Address - Country:US
Practice Address - Phone:833-665-2170
Practice Address - Fax:833-665-2171
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:3D RX, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-31
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy