Provider Demographics
NPI:1730835018
Name:PROACTIVE HEALTHRX LLC
Entity type:Organization
Organization Name:PROACTIVE HEALTHRX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-452-3162
Mailing Address - Street 1:7161 160TH LN N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418-7480
Mailing Address - Country:US
Mailing Address - Phone:561-452-3162
Mailing Address - Fax:
Practice Address - Street 1:801 NORTHPOINT PKWY STE 19
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1991
Practice Address - Country:US
Practice Address - Phone:855-526-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care