Provider Demographics
NPI:1922500701
Name:IMPERIAL RX LLC
Entity Type:Organization
Organization Name:IMPERIAL RX LLC
Other - Org Name:IMPERIAL RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMACCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-552-3452
Mailing Address - Street 1:182 ROCKINGHAM RD UNIT 2
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-2155
Mailing Address - Country:US
Mailing Address - Phone:603-552-3452
Mailing Address - Fax:
Practice Address - Street 1:182 ROCKINGHAM RD UNIT 2
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-2155
Practice Address - Country:US
Practice Address - Phone:603-552-3452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy