=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831788595
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 10RX LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2021
-----------------------------------------------------
Last Update Date | 10/12/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1941 SE PORT ST LUCIE BLVD
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34952-5535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-296-5525
-----------------------------------------------------
Fax | 844-776-0098
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1941 SE PORT ST LUCIE BLVD
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34952-5535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-296-5525
-----------------------------------------------------
Fax | 844-776-0098
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. SUDHEER SENKESI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-674-3174
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336M0002X
-----------------------------------------------------
Taxonomy Name | Mail Order Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------