Provider Demographics
NPI:1801468541
Name:QRCPC PHARMACY, INC
Entity type:Organization
Organization Name:QRCPC PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:R
Authorized Official - Last Name:MIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-388-4333
Mailing Address - Street 1:5620 CHERRY ST STE A
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-6734
Mailing Address - Country:US
Mailing Address - Phone:850-388-4333
Mailing Address - Fax:850-388-4338
Practice Address - Street 1:5620 CHERRY ST STE A
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32404-6734
Practice Address - Country:US
Practice Address - Phone:850-388-4333
Practice Address - Fax:850-388-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition