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General NPI Number Information
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NPI Number | 1750750394
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Entity Type | Organization
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Legal Business Name | MY RX LLC
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 11/21/2018
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Provider Practice Location Address
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Address Line | 170 DR ARLA WAY STE 105
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City | LOUISVILLE
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State | KY
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Zip | 40229-5454
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Country | US
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Telephone | 502-277-1425
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Fax | 502-277-1427
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Provider Business Mailing Address
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Address Line | 170 DR ARLA WAY STE 105
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City | LOUISVILLE
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State | KY
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Zip | 40229-5454
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Country | US
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Telephone | 502-277-1425
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Fax | 502-277-1427
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | REBECCA FLETCHER
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Credential | PHARMD
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Telephone | 502-439-7738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P07716
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License Number State | KY
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