Provider Demographics
NPI:1972255545
Name:DELIVERRX LLC
Entity Type:Organization
Organization Name:DELIVERRX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ABENA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU-ANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:331-250-3527
Mailing Address - Street 1:238 CHARLESTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4133
Mailing Address - Country:US
Mailing Address - Phone:331-250-3527
Mailing Address - Fax:
Practice Address - Street 1:1236 W BOUGHTON RD
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-6568
Practice Address - Country:US
Practice Address - Phone:331-250-3527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site