Healthcare Provider Details
I. General information
NPI: 1780811380
Provider Name (Legal Business Name): TRANSPARENTRX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2009
Last Update Date: 12/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2620 CENTENNIAL RD STE G
TOLEDO OH
43617-1800
US
IV. Provider business mailing address
2850 W HORIZON RIDGE PKWY SUITE 200
HENDERSON NV
89052-4395
US
V. Phone/Fax
- Phone: 866-499-1940
- Fax: 866-515-9591
- Phone: 866-499-1940
- Fax: 248-274-1072
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | MOP 021957250 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336M0002X |
| Taxonomy | Mail Order Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TYRONE
SQUIRES
Title or Position: MANAGING DIRECTOR
Credential: MBA
Phone: 866-499-1940