MEDICARE: NOVA 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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1861320905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA RX LLC

Provider Business Mailing Address
First Line	:	2408 ASHLEY RIVER RD UNIT R
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-4619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 ASHLEY RIVER RD UNIT R
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-4619
Country	:	US
Telephone Number	:	267-884-1023
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DEVIN PATEL
Credential	:
Telephone Number	:	404-825-0649

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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