Provider Demographics
NPI:1265123038
Name:CUREXA - WEST, LLC
Entity type:Organization
Organization Name:CUREXA - WEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:KELSO
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-927-0390
Mailing Address - Street 1:45 S NEW YORK RD STE 220
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-3820
Mailing Address - Country:US
Mailing Address - Phone:855-927-0390
Mailing Address - Fax:855-927-0392
Practice Address - Street 1:1343 N COLORADO ST STE 109
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-1618
Practice Address - Country:US
Practice Address - Phone:855-927-0390
Practice Address - Fax:855-927-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy