Organization
REBEL RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENE JAVIER RODRIGUEZ PHARMD (OWNER)
(201) 233-2460
Entity
Organization
Contact information
Practice address
178 EAGLE ROCK AVE, UNIT 4, ROSELAND, NJ 07068
(973) 226-1200
(973) 226-1210
Mailing address
649 S BEVERYWYCK RD, PARSIPPANY, NJ 07054
(201) 233-2460
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0506788
—
NJ
Enumeration date
08/01/2014
Last updated
03/22/2022
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