Provider Demographics
NPI:1750632717
Name:SAI RX LLC
Entity Type:Organization
Organization Name:SAI RX LLC
Other - Org Name:STAY WELL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:UMAMAHESWARARAO
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIDU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:904-200-8673
Mailing Address - Street 1:2747 BLANDING BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5653
Mailing Address - Country:US
Mailing Address - Phone:904-214-3747
Mailing Address - Fax:904-406-9472
Practice Address - Street 1:2747 BLANDING BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-5653
Practice Address - Country:US
Practice Address - Phone:904-214-3747
Practice Address - Fax:904-406-9472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-30
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH263663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007154300Medicaid
2137205OtherPK