Provider Demographics
NPI:1457758633
Name:SPECIALTY RX
Entity Type:Organization
Organization Name:SPECIALTY RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COLLECTIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:O
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-241-6337
Mailing Address - Street 1:209 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2015
Mailing Address - Country:US
Mailing Address - Phone:908-241-6337
Mailing Address - Fax:908-634-4022
Practice Address - Street 1:209 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-2015
Practice Address - Country:US
Practice Address - Phone:908-241-6337
Practice Address - Fax:908-634-4022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy