Provider Demographics
NPI:1154170637
Name:COMMERCE RX CORPORATION
Entity type:Organization
Organization Name:COMMERCE RX CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:BRANCH
Authorized Official - Last Name:WARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-299-7741
Mailing Address - Street 1:PO BOX 1158
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-1158
Mailing Address - Country:US
Mailing Address - Phone:662-441-7979
Mailing Address - Fax:662-796-3002
Practice Address - Street 1:117 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2735
Practice Address - Country:US
Practice Address - Phone:662-299-7741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS200013226Medicaid