Healthcare Provider Details

I. General information

NPI: 1821842816
Provider Name (Legal Business Name): MYRXWALLET, CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8494 RUSHFIELD AVE
LAS VEGAS NV
89178-4807
US

IV. Provider business mailing address

7995 BLUE DIAMOND RD STE 102-638
LAS VEGAS NV
89178-9301
US

V. Phone/Fax

Practice location:
  • Phone: 702-559-3489
  • Fax:
Mailing address:
  • Phone: 702-546-8686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: CHANH TRINH
Title or Position: TECHNOLOGY ARCHITECT
Credential: DIRECTOR
Phone: 702-546-8686