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General NPI Number Information
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NPI Number | 1093230831
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Entity Type | Organization
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Legal Business Name | RX HEALTHCARE SYSTEM LLC
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Dates
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Enumeration Date | 08/12/2017
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Last Update Date | 08/12/2017
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Provider Practice Location Address
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Address Line | 3755 S NOVA RD STE A
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City | PORT ORANGE
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State | FL
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Zip | 32129-4282
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Country | US
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Telephone | 321-946-6332
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Fax |
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Provider Business Mailing Address
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Address Line | 3755 SOUTH NOVA ROAD UNIT# A
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City | PORT ORANGE
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State | FL
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Zip | 32129
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Country | US
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Telephone | 321-946-6332
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KALPESHKUMAR C PATEL
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Credential | PHARMACIST
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Telephone | 321-946-6332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH30903
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License Number State | FL
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