Provider Demographics
NPI:1932887288
Name:JANUS RX LLC
Entity Type:Organization
Organization Name:JANUS RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, HR
Authorized Official - Prefix:
Authorized Official - First Name:JANUARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-819-4511
Mailing Address - Street 1:3480 EASTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-1700
Mailing Address - Country:US
Mailing Address - Phone:334-819-4500
Mailing Address - Fax:334-819-4520
Practice Address - Street 1:746 OLD SPARTANBURG HWY
Practice Address - Street 2:
Practice Address - City:WELLFORD
Practice Address - State:SC
Practice Address - Zip Code:29385-9668
Practice Address - Country:US
Practice Address - Phone:864-249-0577
Practice Address - Fax:864-249-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7Z1264Medicaid