Provider Demographics
NPI:1790375772
Name:AMERIGEN RX
Entity Type:Organization
Organization Name:AMERIGEN RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VU
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-941-7575
Mailing Address - Street 1:1001 VIRGINIA AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1367
Mailing Address - Country:US
Mailing Address - Phone:404-941-7575
Mailing Address - Fax:404-941-7167
Practice Address - Street 1:1001 VIRGINIA AVE STE 360
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1367
Practice Address - Country:US
Practice Address - Phone:404-941-7575
Practice Address - Fax:404-941-7167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy