Healthcare Provider Details

I. General information

NPI: 1770931677
Provider Name (Legal Business Name): PHARMAMEDRX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17006 SEVEN PINES DR STE 500 SUITE 500
SPRING TX
77379-5562
US

IV. Provider business mailing address

1201 US HIGHWAY 1 STE 1
NORTH PALM BEACH FL
33408-3550
US

V. Phone/Fax

Practice location:
  • Phone: 866-855-6468
  • Fax:
Mailing address:
  • Phone: 866-855-6468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MOONEY THOMPSON
Title or Position: DIRECTOR OF PHARMACY OPERATIONS
Credential:
Phone: 866-855-6468