Provider Demographics
NPI:1124273230
Name:ON SITE RX INC
Entity type:Organization
Organization Name:ON SITE RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-532-1551
Mailing Address - Street 1:PO BOX 7036
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30502-0036
Mailing Address - Country:US
Mailing Address - Phone:770-532-1551
Mailing Address - Fax:770-536-7519
Practice Address - Street 1:620 E 11TH ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3101
Practice Address - Country:US
Practice Address - Phone:423-266-1586
Practice Address - Fax:423-266-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TN00000045973336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2117896OtherPK