Provider Demographics
NPI:1902511413
Name:MEDIRX, LLC
Entity Type:Organization
Organization Name:MEDIRX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:JELE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:774-486-9102
Mailing Address - Street 1:13 MOORE DR
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-2519
Mailing Address - Country:US
Mailing Address - Phone:774-486-9102
Mailing Address - Fax:
Practice Address - Street 1:13 MOORE DR
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527-2519
Practice Address - Country:US
Practice Address - Phone:774-486-9102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health