MEDICARE: BREWSTER RX 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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	041289	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1275333692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREWSTER RX LLC

Provider Business Mailing Address
First Line	:	2505 CARMEL AVE STE 111-112
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-1155
Country	:	US
Telephone Number	:	845-278-8200
Fax Number	:	845-278-4340

Provider Business Practice Location Address
First Line	:	2505 CARMEL AVE STE 111-112
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-1155
Country	:	US
Telephone Number	:	845-278-8200
Fax Number	:	845-278-4340

Authorized Official
Title or Position	:	MANAGER
Name	:	LOKESWARA R KALAKOTI
Credential	:
Telephone Number	:	845-278-8200

Provider Enumeration Date	:	03/14/2025
Last Update Date	:	05/07/2025

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Directions to “BREWSTER RX LLC ” Practice Location

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