Healthcare Provider Details

I. General information

NPI: 1619035219
Provider Name (Legal Business Name): RX IV INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1938 WOODSLEE DR SUITE 200
TROY MI
48083-2235
US

IV. Provider business mailing address

1938 WOODSLEE DR SUITE 200
TROY MI
48083-2235
US

V. Phone/Fax

Practice location:
  • Phone: 248-435-9400
  • Fax: 248-619-9624
Mailing address:
  • Phone: 248-435-9400
  • Fax: 248-619-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number5301005865
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number5301005865
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberBR3638232
License Number StateMI

VIII. Authorized Official

Name: GREGORY JAMIAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 248-435-9400