Basic Information
Provider Information
NPI: 1700464591
EntityType: 2
ReplacementNPI:  
OrganizationName: JANUS RX
LastName:  
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Credential:  
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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: 5000 FALLS OF NEUSE RD STE 300
Address2:  
City: RALEIGH
State: NC
PostalCode: 276095480
CountryCode: US
TelephoneNumber: 9842001549
FaxNumber: 9842002542
Other Information
ProviderEnumerationDate: 04/01/2021
LastUpdateDate: 03/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MILLER
AuthorizedOfficialFirstName: JANUARY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VP, HR
AuthorizedOfficialTelephone: 3348194511
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 03/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3336L0003X  Y SuppliersPharmacyLong Term Care Pharmacy

No ID Information.


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