Organization
PRXP OF CA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS WAKEFIELD (CORPORATE MANAGER)
(412) 477-7803
Entity
Organization
Contact information
Practice address
4345 E LOWELL ST, SUITES C AND D, ONTARIO, CA 91761-2222
(760) 326-2312
(760) 326-4178
Mailing address
4345 E LOWELL ST, SUITES C & D, ONTARIO, CA 91761-2222
(888) 505-1485
(888) 505-1485
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY55795
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162397
PK
—
Enumeration date
10/12/2015
Last updated
04/11/2024
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