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General NPI Number Information
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NPI Number | 1104665173
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Entity Type | Organization
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Legal Business Name | PRXP OF CA LLC
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Dates
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Enumeration Date | 05/21/2024
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 4345 E LOWELL ST STE C&D
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City | ONTARIO
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State | CA
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Zip | 91761-2222
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Country | US
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Telephone | 888-505-1485
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Fax | 888-505-1485
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Provider Business Mailing Address
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Address Line | 1193 BEECHWOOD BLVD
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City | PITTSBURGH
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State | PA
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Zip | 15206-4545
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Country | US
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Telephone | 412-477-7803
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHRIS WAKEFIELD
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Credential |
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Telephone | 412-477-7803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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