Provider Demographics
NPI:1952532517
Name:UNITED RX LLC
Entity Type:Organization
Organization Name:UNITED RX LLC
Other - Org Name:UNITED RX, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BENAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-375-5704
Mailing Address - Street 1:150 FENCL LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-2041
Mailing Address - Country:US
Mailing Address - Phone:708-449-7600
Mailing Address - Fax:855-422-0782
Practice Address - Street 1:150 FENCL LN
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-2041
Practice Address - Country:US
Practice Address - Phone:708-449-7600
Practice Address - Fax:855-422-0782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN64001052A333600000X
OHNRPS.022500850-033336L0003X
IL054.0176203336L0003X
MO20140325043336L0003X
KS22-447463336L0003X
PANP0003223336L0003X
WI1415-433336L0003X
MI53010107293336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201109830AMedicaid
2121566OtherPK
OH0153914Medicaid
MO1952532517Medicaid
IN200976860AMedicaid
KY7100377850Medicaid
WI100043156Medicaid
MI1952532517Medicaid
KS201109830AMedicaid
KY7100377850Medicaid