MEDICARE: ADVANCED RX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	526	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2003533	OTHER		PK

General Provider Information

NPI Number	:	1417028424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED RX LLC

Provider Business Mailing Address
First Line	:	1058 S FEDERAL BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-4102
Country	:	US
Telephone Number	:	303-975-1700
Fax Number	:	303-975-1799

Provider Business Practice Location Address
First Line	:	1058 S FEDERAL BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-4102
Country	:	US
Telephone Number	:	303-975-1700
Fax Number	:	303-975-1799

Authorized Official
Title or Position	:	OWNER
Name	:	ELISE NGUYEN
Credential	:	RPH
Telephone Number	:	303-975-1700

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	09/19/2025

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Directions to “ADVANCED RX LLC ” Practice Location

Language	Start Address	Practice Location

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