Provider Demographics
NPI:1174892319
Name:LIVE RX PHARMACY INC
Entity type:Organization
Organization Name:LIVE RX PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-332-2363
Mailing Address - Street 1:4750 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1452
Mailing Address - Country:US
Mailing Address - Phone:786-332-2363
Mailing Address - Fax:786-332-2369
Practice Address - Street 1:4750 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1452
Practice Address - Country:US
Practice Address - Phone:786-332-2363
Practice Address - Fax:786-332-2369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-16
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH258423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133144OtherPK