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NPI Code Detail

MEDICARE: UNITED RX, LLC

MEDICARE: UNITED RX, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336L0003XLong Term Care Pharmacy054017653IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11487140OTHERILNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
36381180001OTHERDME PTAN

General Provider Information

NPI Number : 1598014581
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED RX, LLC
Provider Business Mailing Address
First Line : 1120 W. MAIN STREET
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-1929
Country : US
Telephone Number : 877-896-7090
Fax Number : 618-457-7407
Provider Business Practice Location Address
First Line : 1120 W. MAIN STREET
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-1929
Country : US
Telephone Number : 708-375-5736
Fax Number : 708-377-9029
Authorized Official
Title or Position : CEO / OWNER
Name : CHARLES STEVEN BENAIN
Credential :
Telephone Number : 708-449-7600
Provider Enumeration Date : 09/05/2012
Last Update Date : 05/23/2024

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Directions to “UNITED RX, LLC ” Practice Location

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