Provider Demographics
NPI:1356800551
Name:DWH DIRECT RX LLC
Entity type:Organization
Organization Name:DWH DIRECT RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-419-3388
Mailing Address - Street 1:524 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1216
Mailing Address - Country:US
Mailing Address - Phone:610-419-3388
Mailing Address - Fax:610-419-3266
Practice Address - Street 1:524 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1216
Practice Address - Country:US
Practice Address - Phone:610-419-3388
Practice Address - Fax:610-419-3266
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DWH DIRECT RX LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy