Provider Demographics
NPI:1881411494
Name:PRESCRIPTRX PHARMACY LLC
Entity type:Organization
Organization Name:PRESCRIPTRX PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:BARON
Authorized Official - Last Name:QUINONEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:754-200-5913
Mailing Address - Street 1:1523 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-5717
Mailing Address - Country:US
Mailing Address - Phone:754-200-5913
Mailing Address - Fax:754-223-3424
Practice Address - Street 1:1523 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-5717
Practice Address - Country:US
Practice Address - Phone:754-200-5913
Practice Address - Fax:754-223-3424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESCRIPTRX PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy