Provider Demographics
NPI:1700242898
Name:PRIMERX, INC.
Entity type:Organization
Organization Name:PRIMERX, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREAUSRER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:
Authorized Official - Last Name:MANEK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:630-747-7495
Mailing Address - Street 1:3109 W ARMITAGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3818
Mailing Address - Country:US
Mailing Address - Phone:773-292-5555
Mailing Address - Fax:
Practice Address - Street 1:3109 W ARMITAGE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-3818
Practice Address - Country:US
Practice Address - Phone:773-292-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0540196883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy