Provider Demographics
NPI:1073330387
Name:RX PHARMACY LLC
Entity type:Organization
Organization Name:RX PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:GAWRONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:224-316-0979
Mailing Address - Street 1:1221 S LEO CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2388
Mailing Address - Country:US
Mailing Address - Phone:224-316-0979
Mailing Address - Fax:847-485-8181
Practice Address - Street 1:1725 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-5401
Practice Address - Country:US
Practice Address - Phone:847-621-2103
Practice Address - Fax:847-485-8181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RX PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy