Provider Demographics
NPI:1750980595
Name:WARRENRX LLC
Entity type:Organization
Organization Name:WARRENRX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIKHO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:247-376-6855
Mailing Address - Street 1:31500 DEQUINDRE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-1057
Mailing Address - Country:US
Mailing Address - Phone:248-376-6855
Mailing Address - Fax:
Practice Address - Street 1:31500 DEQUINDRE RD STE 300
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-1057
Practice Address - Country:US
Practice Address - Phone:248-376-6855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy