Provider Demographics
NPI:1457194508
Name:RXVIP PA LLC
Entity type:Organization
Organization Name:RXVIP PA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-674-3693
Mailing Address - Street 1:503 RAILROAD AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-1342
Mailing Address - Country:US
Mailing Address - Phone:814-674-3693
Mailing Address - Fax:814-674-5446
Practice Address - Street 1:503 RAILROAD AVE STE 2
Practice Address - Street 2:
Practice Address - City:PATTON
Practice Address - State:PA
Practice Address - Zip Code:16668-1342
Practice Address - Country:US
Practice Address - Phone:814-674-3693
Practice Address - Fax:814-674-5446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy