Provider Demographics
NPI:1750327219
Name:RX ADVANTAGE INC
Entity Type:Organization
Organization Name:RX ADVANTAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARUSCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:850-478-7923
Mailing Address - Street 1:2256 W NINE MILE RD STE B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534-9471
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2256 W NINE MILE RD STE B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32534-9471
Practice Address - Country:US
Practice Address - Phone:850-478-7923
Practice Address - Fax:850-478-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH00171233336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100003206Medicaid
SCH17123Medicaid
1088702OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1088702OtherOTHER ID NUMBER
FL021966500Medicaid