Provider Demographics
NPI:1679917611
Name:ON-SITE RX
Entity type:Organization
Organization Name:ON-SITE RX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR OF PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-532-1551
Mailing Address - Street 1:PO BOX 7036
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30502-0036
Mailing Address - Country:US
Mailing Address - Phone:770-532-1551
Mailing Address - Fax:770-536-7519
Practice Address - Street 1:817 BOTETOURT CT
Practice Address - Street 2:STE. 103
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4886
Practice Address - Country:US
Practice Address - Phone:757-410-2775
Practice Address - Fax:757-410-2790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010045113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy