Provider Demographics
NPI:1881067833
Name:PRX LLC
Entity type:Organization
Organization Name:PRX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORY
Authorized Official - Middle Name:EMILE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:601-909-6274
Mailing Address - Street 1:814 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-4259
Mailing Address - Country:US
Mailing Address - Phone:601-909-6274
Mailing Address - Fax:601-909-6287
Practice Address - Street 1:814 W PINE ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-4259
Practice Address - Country:US
Practice Address - Phone:601-909-6274
Practice Address - Fax:601-909-6287
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARMACYRXTOX, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment