Provider Demographics
NPI:1053018507
Name:UNITED/XCEL-RX LLC
Entity type:Organization
Organization Name:UNITED/XCEL-RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CONTRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-375-5736
Mailing Address - Street 1:4300 N UNIVERSITY DR STE C101
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6243
Mailing Address - Country:US
Mailing Address - Phone:754-231-2300
Mailing Address - Fax:855-239-2300
Practice Address - Street 1:4300 N UNIVERSITY DR STE C101
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-6243
Practice Address - Country:US
Practice Address - Phone:754-231-2300
Practice Address - Fax:855-239-2300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED/XCEL-RX LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-14
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy