Healthcare Provider Details

I. General information

NPI: 1245320233
Provider Name (Legal Business Name): RX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11155 ABERCORN ST
SAVANNAH GA
31405
US

IV. Provider business mailing address

612 E 69TH ST
SAVANNAH GA
31405
US

V. Phone/Fax

Practice location:
  • Phone: 912-352-0375
  • Fax: 912-356-9609
Mailing address:
  • Phone: 912-352-0375
  • Fax: 912-356-9609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6638
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1135044
Identifier TypeOTHER
Identifier State
Identifier IssuerNCPDP

VIII. Authorized Official

Name: MR. JOHN MCKINNON
Title or Position: VICE-PRESIDENT
Credential:
Phone: 912-927-1766