Provider Demographics
NPI:1366831836
Name:MAR RX INC
Entity type:Organization
Organization Name:MAR RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-389-9229
Mailing Address - Street 1:3491 S CONGRESS AVE
Mailing Address - Street 2:BAY 6
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3021
Mailing Address - Country:US
Mailing Address - Phone:561-432-0402
Mailing Address - Fax:561-432-0403
Practice Address - Street 1:3491 S CONGRESS AVE
Practice Address - Street 2:BAY 6
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3021
Practice Address - Country:US
Practice Address - Phone:561-432-0402
Practice Address - Fax:561-432-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH2287063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149708OtherPK