Provider Demographics
NPI:1952946816
Name:RX UNIVERSAL LLC
Entity Type:Organization
Organization Name:RX UNIVERSAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GERSHON
Authorized Official - Middle Name:GENNADY
Authorized Official - Last Name:BATUROV
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:855-900-8414
Mailing Address - Street 1:3165 BUFORD HWY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3351
Mailing Address - Country:US
Mailing Address - Phone:855-900-8414
Mailing Address - Fax:855-710-7101
Practice Address - Street 1:3165 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3351
Practice Address - Country:US
Practice Address - Phone:855-900-8414
Practice Address - Fax:855-710-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPHRE010802OtherGEORGIA BOARD OF PHARMACY