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NPI Code Detail

MEDICARE: PRESCRIPTRX PHARMACY LLC

MEDICARE: PRESCRIPTRX PHARMACY 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
13336L0003XLong Term Care Pharmacy
2333600000XPharmacy
33336C0003XCommunity/Retail PharmacyPH30284FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12162423OTHERPK

General Provider Information

NPI Number : 1578927166
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESCRIPTRX PHARMACY LLC
Provider Business Mailing Address
First Line : 1523 E COMMERCIAL BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33334-5717
Country : US
Telephone Number : 754-200-5913
Fax Number : 754-223-3424
Provider Business Practice Location Address
First Line : 1523 E COMMERCIAL BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33334-5717
Country : US
Telephone Number : 754-200-5913
Fax Number : 754-223-3424
Authorized Official
Title or Position : OWNER, MANAGER, PIC, AO
Name : LISA QUINONEZ
Credential : RPH
Telephone Number : 561-997-4424
Provider Enumeration Date : 04/08/2016
Last Update Date : 09/24/2024

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Directions to “PRESCRIPTRX PHARMACY LLC ” Practice Location

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