Provider Demographics
NPI:1437330289
Name:RIVER RX INC
Entity type:Organization
Organization Name:RIVER RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:DHALLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-412-6495
Mailing Address - Street 1:13526 BONNIE DALE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3904
Mailing Address - Country:US
Mailing Address - Phone:301-654-6979
Mailing Address - Fax:
Practice Address - Street 1:5257 RIVER RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1415
Practice Address - Country:US
Practice Address - Phone:301-654-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP047093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2038348OtherPK