Provider Demographics
NPI:1013901065
Name:CHOICE RX INC
Entity Type:Organization
Organization Name:CHOICE RX INC
Other - Org Name:RX PLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERLANDY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:VILLARAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-776-1020
Mailing Address - Street 1:1425 E LINCOLN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2257
Mailing Address - Country:US
Mailing Address - Phone:714-776-1020
Mailing Address - Fax:714-776-7053
Practice Address - Street 1:1425 E LINCOLN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2209
Practice Address - Country:US
Practice Address - Phone:714-776-1020
Practice Address - Fax:714-776-7053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY55627333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA431530Medicaid
1283460001Medicare NSC