MEDICARE: NYRX PHARMA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1245956655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYRX PHARMA, LLC

Provider Business Mailing Address
First Line	:	14 STACEY COURT
Second Line	:
City	:	PEEKSKILL
State	:	NY
Zip	:	10566-2507
Country	:	US
Telephone Number	:	914-402-1900
Fax Number	:	914-402-1905

Provider Business Practice Location Address
First Line	:	903 B SHERIDAN AVENUE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-3305
Country	:	US
Telephone Number	:	718-588-0761
Fax Number	:	914-402-1905

Authorized Official
Title or Position	:	MEMBER
Name	:	MR. NADER A. YOUSSEF
Credential	:
Telephone Number	:	914-402-1900

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	10/17/2022

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