Provider Demographics
NPI:1912231309
Name:RX CENTRAL, INC.
Entity Type:Organization
Organization Name:RX CENTRAL, INC.
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LONG
Authorized Official - Middle Name:V
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-524-3214
Mailing Address - Street 1:807 DAVIDSON DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4351
Mailing Address - Country:US
Mailing Address - Phone:704-786-0135
Mailing Address - Fax:704-786-1018
Practice Address - Street 1:807 DAVIDSON DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4351
Practice Address - Country:US
Practice Address - Phone:704-786-0135
Practice Address - Fax:704-786-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0136069Medicaid
NC0136069Medicaid