Provider Demographics
NPI:1720783327
Name:PUBLIC DRUG RX
Entity Type:Organization
Organization Name:PUBLIC DRUG RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-931-9271
Mailing Address - Street 1:6925 LUDLOW ST
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-2304
Mailing Address - Country:US
Mailing Address - Phone:610-931-9271
Mailing Address - Fax:
Practice Address - Street 1:6925 LUDLOW ST
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-2304
Practice Address - Country:US
Practice Address - Phone:610-931-9271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy