Provider Demographics
NPI:1912347998
Name:RX EXPRESS PHARMACY OF PANAMA CITY INC
Entity Type:Organization
Organization Name:RX EXPRESS PHARMACY OF PANAMA CITY INC
Other - Org Name:RX EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:850-215-7455
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32402-0310
Mailing Address - Country:US
Mailing Address - Phone:850-215-7455
Mailing Address - Fax:
Practice Address - Street 1:3104 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-1829
Practice Address - Country:US
Practice Address - Phone:850-215-7455
Practice Address - Fax:850-215-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-05
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
FLPH269373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26937OtherPHARMACY LICENSE
FL26937OtherPHARMACY LICENSE