Provider Demographics
NPI:1790066348
Name:RX AMERICA
Entity Type:Organization
Organization Name:RX AMERICA
Other - Org Name:BERKSHIRE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VERIDIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-580-2983
Mailing Address - Street 1:11 BERKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-3632
Mailing Address - Country:US
Mailing Address - Phone:650-216-9800
Mailing Address - Fax:650-216-9805
Practice Address - Street 1:11 BERKSHIRE AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-3632
Practice Address - Country:US
Practice Address - Phone:650-216-9800
Practice Address - Fax:650-216-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336M0002X
CA538943336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2138317OtherPK