Healthcare Provider Details

I. General information

NPI: 1053817007
Provider Name (Legal Business Name): JANUS RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 09/19/2025
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2697 INTERNATIONAL PKWY BLDG 3
VIRGINIA BEACH VA
23452-7803
US

IV. Provider business mailing address

3480 EASTERN BLVD
MONTGOMERY AL
36116-1700
US

V. Phone/Fax

Practice location:
  • Phone: 757-351-1951
  • Fax: 757-351-1951
Mailing address:
  • Phone: 334-819-4500
  • Fax: 334-819-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0201004781
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JANUARY GREEN
Title or Position: VP, HUMAN RESOURCES
Credential:
Phone: 334-819-4500