Provider Demographics
NPI:1679049175
Name:RX ASSOCIATES LLC
Entity type:Organization
Organization Name:RX ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:OUELLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:207-834-2880
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-0189
Mailing Address - Country:US
Mailing Address - Phone:207-834-2880
Mailing Address - Fax:207-834-2882
Practice Address - Street 1:711 BROADWAY STE 2
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3225
Practice Address - Country:US
Practice Address - Phone:207-922-3849
Practice Address - Fax:207-834-2882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RX ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-23
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEPH50001675OtherSTATE OF MAINE BOARD OF PHARMACY