Provider Demographics
NPI:1649922139
Name:PROFICIENT RX LP
Entity type:Organization
Organization Name:PROFICIENT RX LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DESTRY
Authorized Official - Middle Name:T
Authorized Official - Last Name:SETSER
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT, DRIC, DR
Authorized Official - Phone:800-787-7824
Mailing Address - Street 1:3607 OLD CONEJO RD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2123
Mailing Address - Country:US
Mailing Address - Phone:800-787-7824
Mailing Address - Fax:800-626-5004
Practice Address - Street 1:3607 OLD CONEJO RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-2123
Practice Address - Country:US
Practice Address - Phone:800-787-7824
Practice Address - Fax:800-626-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies