Provider Demographics
NPI:1265597447
Name:RXPLUS LIMITED PALISADE LLC
Entity type:Organization
Organization Name:RXPLUS LIMITED PALISADE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:970-464-5668
Mailing Address - Street 1:707 ELBERTA AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PALISADE
Mailing Address - State:CO
Mailing Address - Zip Code:81526-8806
Mailing Address - Country:US
Mailing Address - Phone:970-464-5668
Mailing Address - Fax:970-464-5664
Practice Address - Street 1:707 ELBERTA AVE UNIT B
Practice Address - Street 2:
Practice Address - City:PALISADE
Practice Address - State:CO
Practice Address - Zip Code:81526-8806
Practice Address - Country:US
Practice Address - Phone:970-464-5668
Practice Address - Fax:970-464-5664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 3336M0002X, 3336S0011X, 3336C0003X, 3336M0002X
COPDO.10100000013336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000158841Medicaid
2001134OtherPK
2001134OtherPK