1245650647 NPI number — RX DISCOUNT PHARMACY INC

Table of content: (NPI 1245650647)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245650647 NPI number — RX DISCOUNT PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RX DISCOUNT PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
QUALITY CARE MEDICAL EQUIPMENT & SCRUBS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245650647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1569
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAZARD
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41702-1569
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-436-2407
Provider Business Mailing Address Fax Number:
606-436-0727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
132 GRAND VUE PLZ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZARD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41701-6842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-436-9900
Provider Business Practice Location Address Fax Number:
606-436-9903
Provider Enumeration Date:
04/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
SLONE
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
606-436-2407

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  HME00804 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2147083 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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