Alixa RX LLC

Organization Active NPI Long Term Care Pharmacy · Lenexa, KS

NPI 1316200330 · NPPES record last updated Nov 20, 2023

Key facts

NPI
1316200330
Entity type
Organization (NPI type 2)
Primary specialty
Long Term Care Pharmacy 3336L0003X
Legal business name
ALIXA RX LLC
Practice address
11286 Renner Blvd
Lenexa, KS 66219-9605
Phone
(972) 372-6300
NPI assigned
Jun 25, 2012
Organization subpart
Yes
Parent organization (as reported)
MARINA PHARMACY CORP.

Authorized official

Name
Michael Shamalov
Title
Managing Member
Phone
(631) 321-3850

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 6

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Alixa RX - Kansas
11286 Renner Blvd, Lenexa, KS 66219-9605 · (913) 307-8150
Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignment
Participating since Dec 1, 2020

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in KS, MO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210309000169 KS Part B Supplier - Pharmacy 0345474102 Practice locations: Wichita, KS; Eskridge, KS; Springhill, KS; Olathe, KS; Lansing, KS; Edwardsville, KS
O20210429001113 MO Part B Supplier - Pharmacy 0345474102 Practice locations: Kansas City, MO
O20240412003504 KS DME Supplier - Pharmacy 0345474102 Practice locations: Lenexa, KS

National Provider Directory

Tax ID family
Alixa RX LLC (7 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X Yes

Addresses

Primary practice location

11286 Renner Blvd
Lenexa, KS 66219-9605

Mailing address

11286 Renner Blvd
Lenexa, KS 66219-9605
Phone (972) 372-6300

Other names

  • Alixa RX Doing business as

Other providers in Lenexa, KS

All providers in Lenexa, KS · Long Term Care Pharmacy in Kansas

Sources for this page

Verify at the official NPI Registry.