Provider Demographics
NPI:1760044986
Name:ERIC'S RX LLC
Entity Type:Organization
Organization Name:ERIC'S RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:OST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-646-4800
Mailing Address - Street 1:810 WELSH RD
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1011
Mailing Address - Country:US
Mailing Address - Phone:215-646-4800
Mailing Address - Fax:215-646-4885
Practice Address - Street 1:810 WELSH RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-1011
Practice Address - Country:US
Practice Address - Phone:215-646-4800
Practice Address - Fax:215-646-4885
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERIC'S RX LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1036223570001Medicaid