Provider Demographics
NPI:1215258678
Name:RX NUTRITIONAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:RX NUTRITIONAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL SIGNORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-779-8849
Mailing Address - Street 1:8040 CASTLEWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1915
Mailing Address - Country:US
Mailing Address - Phone:317-863-6320
Mailing Address - Fax:
Practice Address - Street 1:8040 CASTLEWAY DRIVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1915
Practice Address - Country:US
Practice Address - Phone:317-863-6320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60006226A332B00000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies