Provider Demographics
NPI:1053396382
Name:NATURES RX INC
Entity type:Organization
Organization Name:NATURES RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DREW
Authorized Official - Last Name:POLCER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-740-4888
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-0658
Mailing Address - Country:US
Mailing Address - Phone:856-740-4888
Mailing Address - Fax:856-740-0559
Practice Address - Street 1:2007 N BLACKHORSE PIKE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-9120
Practice Address - Country:US
Practice Address - Phone:856-740-4888
Practice Address - Fax:856-740-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB048582207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ067914Medicare PIN