Healthcare Provider Details

I. General information

NPI: 1578916466
Provider Name (Legal Business Name): MEDSRX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 CALLE RECODO
SAN CLEMENTE CA
92673-6237
US

IV. Provider business mailing address

1011 CALLE RECODO
SAN CLEMENTE CA
92673-6237
US

V. Phone/Fax

Practice location:
  • Phone: 949-303-1053
  • Fax: 949-326-0347
Mailing address:
  • Phone: 949-303-1053
  • Fax: 949-326-0347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY55595
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRIS VO
Title or Position: MANAGER
Credential:
Phone: 949-303-1053