Quickrx LLC
Organization Active NPI Pharmacist · Brewster, WA
NPI 1093880908 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1093880908
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- Legal business name
- QUICKRX LLC
- Practice address
- 811 US Hwy 97
Brewster, WA 98812 - Phone
- (509) 689-2421
- Fax
- (509) 689-2068
- NPI assigned
- Nov 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Umesh Gajjala
- Title
- Owner
- Phone
- (732) 986-5593
Corporate family (same tax ID) 1
Member of 1
Member organizations 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210601002712 | WA | Part B Supplier - Mass Immunization (Roster Biller Only) | 3173922721 | Practice locations: Brewster, WA |
| O20240325003280 | WA | DME Supplier - Pharmacy | 7315384492 | Practice locations: Brewster, WA |
| O20240502003189 | WA | Part B Supplier - Mass Immunization (Roster Biller Only) | 7315384492 | Practice locations: Brewster, WA |
National Provider Directory
- Tax ID family
- Quickrx LLC
Locations
811 Highway 97
Brewster, WA 98812
Phone (509) 689-2421
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | Yes | ||
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
1835P0018X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHAR.CF.60810882 | WA |
Addresses
Primary practice location
811 US Hwy 97
Brewster, WA 98812
Mailing address
PO Box 2130
Brewster, WA 98812
Phone (509) 689-2421
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2167145 | Medicaid | WA | |
| 2175343 | Other | PK |
Other names
- BREWSTER PHARMACY
Other providers in Brewster, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.