Healthcare Provider Details

I. General information

NPI: 1831194000
Provider Name (Legal Business Name): WRX ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 E MAIN ST
MIDDLEBURG PA
17842-1148
US

IV. Provider business mailing address

239 E MAIN ST
MIDDLEBURG PA
17842-1148
US

V. Phone/Fax

Practice location:
  • Phone: 570-837-6285
  • Fax: 570-837-6403
Mailing address:
  • Phone: 570-837-6285
  • Fax: 570-837-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP410437L
License Number StatePA

VIII. Authorized Official

Name: MR. MICHAEL S WAGNER
Title or Position: PRESIDENT
Credential: RPH
Phone: 570-837-6285