Provider Demographics
NPI:1770931677
Name:PHARMAMEDRX LLC
Entity type:Organization
Organization Name:PHARMAMEDRX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOONEY THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-855-6468
Mailing Address - Street 1:1201 US HIGHWAY 1
Mailing Address - Street 2:STE 1
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3550
Mailing Address - Country:US
Mailing Address - Phone:866-855-6468
Mailing Address - Fax:
Practice Address - Street 1:17006 SEVEN PINES DR STE 500
Practice Address - Street 2:SUITE 500
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-5562
Practice Address - Country:US
Practice Address - Phone:866-855-6468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160421OtherPK