MEDICARE: CENTRAL RX SERVICES, 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
1	333600000X	Pharmacy
2	3336M0002X	Mail Order Pharmacy

General Provider Information

NPI Number	:	1609439280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL RX SERVICES, LLC

Provider Business Mailing Address
First Line	:	1127 BRYN MAWR AVE
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92374-4558
Country	:	US
Telephone Number	:	800-225-5967
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 CENTER CROSSING RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-7047
Country	:	US
Telephone Number	:	702-880-6500
Fax Number	:	702-880-6501

Authorized Official
Title or Position	:	PRESIDENT/TREASURER
Name	:	JOHN M CONROY
Credential	:
Telephone Number	:	800-225-5967

Provider Enumeration Date	:	04/18/2019
Last Update Date	:	06/26/2020

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