Provider Demographics
NPI:1962172213
Name:RECHARGE LLC
Entity type:Organization
Organization Name:RECHARGE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-512-9996
Mailing Address - Street 1:47 SW 17TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8104
Mailing Address - Country:US
Mailing Address - Phone:352-512-9996
Mailing Address - Fax:866-622-5714
Practice Address - Street 1:47 SW 17TH ST STE B
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8104
Practice Address - Country:US
Practice Address - Phone:352-512-9996
Practice Address - Fax:866-622-5714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy