Provider Demographics
NPI:1710725122
Name:NIPPURRX SOLUTIONS
Entity type:Organization
Organization Name:NIPPURRX SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DEPARTMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HANTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-480-8495
Mailing Address - Street 1:33905 STATE ROAD 54 STE 102
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-9100
Mailing Address - Country:US
Mailing Address - Phone:832-480-8495
Mailing Address - Fax:
Practice Address - Street 1:33905 STATE ROAD 54 STE 102
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-9100
Practice Address - Country:US
Practice Address - Phone:832-480-8495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy