=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912397936
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPRX, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2015
-----------------------------------------------------
Last Update Date | 04/18/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6300 WHITE LN SUITE N
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93309-8763
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-282-8805
-----------------------------------------------------
Fax | 661-473-1717
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9508 STOCKDALE HWY #130
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93311-3622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | EDWARD SVIHOVEC
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 661-599-2731
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------