Healthcare Provider Details

I. General information

NPI: 1063837375
Provider Name (Legal Business Name): PATIENT-DIRECT RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OXFORD VALLEY RD STE 1203
YARDLEY PA
19067-7706
US

IV. Provider business mailing address

301 OXFORD VALLEY RD STE 1203
YARDLEY PA
19067-7706
US

V. Phone/Fax

Practice location:
  • Phone: 866-567-1642
  • Fax: 215-323-4106
Mailing address:
  • Phone: 866-567-1642
  • Fax: 215-323-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP482173
License Number StatePA

VIII. Authorized Official

Name: TONY WRIGHT
Title or Position: CFO
Credential:
Phone: 407-971-8708