Provider Demographics
NPI:1588911895
Name:UNITED RX, LLC
Entity type:Organization
Organization Name:UNITED RX, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO-CHIEF-OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BENAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:708-449-7600
Mailing Address - Street 1:2325 POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3294
Mailing Address - Country:US
Mailing Address - Phone:317-536-2299
Mailing Address - Fax:317-815-5645
Practice Address - Street 1:2325 POINTE PKWY
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3294
Practice Address - Country:US
Practice Address - Phone:317-536-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60006309A3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
6381180001OtherDME PTAN
1564182OtherNCPDP PROVIDER IDENTIFICATION NUMBER
IN20097660AMedicaid
6381180001Medicare NSC