Provider Demographics
NPI:1417782525
Name:TABULA RASA HEALTHCARE GROUP, INC
Entity type:Organization
Organization Name:TABULA RASA HEALTHCARE GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP, COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-369-2200
Mailing Address - Street 1:228 STRAWBRIDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-4600
Mailing Address - Country:US
Mailing Address - Phone:888-680-8983
Mailing Address - Fax:856-273-0135
Practice Address - Street 1:228 STRAWBRIDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-4600
Practice Address - Country:US
Practice Address - Phone:888-680-8983
Practice Address - Fax:856-273-0135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TABULA RASA HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy