Provider Demographics
NPI:1760779615
Name:MED EXPRESS RX
Entity Type:Organization
Organization Name:MED EXPRESS RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHISH
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:813-361-2571
Mailing Address - Street 1:608 CITRUS WOOD LN
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-3721
Mailing Address - Country:US
Mailing Address - Phone:813-361-2571
Mailing Address - Fax:813-681-2610
Practice Address - Street 1:1717 SHEPHERD RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-2179
Practice Address - Country:US
Practice Address - Phone:813-361-2571
Practice Address - Fax:813-681-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH255333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy