Basic Information
Provider Information
NPI: 1275273187
EntityType: 2
ReplacementNPI:  
OrganizationName: JANUS RX LLC
LastName:  
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Mailing Information
Address1: 3480 EASTERN BLVD
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361161700
CountryCode: US
TelephoneNumber: 3348194500
FaxNumber:  
Practice Location
Address1: 8521 LA GRANGE RD
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402423800
CountryCode: US
TelephoneNumber: 3348194500
FaxNumber: 3348194520
Other Information
ProviderEnumerationDate: 03/30/2022
LastUpdateDate: 03/30/2022
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: MILLER
AuthorizedOfficialFirstName: JANUARY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP, HR
AuthorizedOfficialTelephone: 3348194511
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate: 03/30/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3336L0003X  Y SuppliersPharmacyLong Term Care Pharmacy

No ID Information.


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