Healthcare Provider Details

I. General information

NPI: 1861320905
Provider Name (Legal Business Name): NOVA RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2408 ASHLEY RIVER RD UNIT R
CHARLESTON SC
29414-4619
US

IV. Provider business mailing address

2408 ASHLEY RIVER RD UNIT R
CHARLESTON SC
29414-4619
US

V. Phone/Fax

Practice location:
  • Phone: 267-884-1023
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DEVIN PATEL
Title or Position: MEMBER
Credential:
Phone: 404-825-0649