MEDICARE: NATIONAL RX PHARMACY INC

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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1326452830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL RX PHARMACY INC

Provider Business Mailing Address
First Line	:	111 HEMPSTEAD TPKE
Second Line	:
City	:	WEST HEMPSTEAD
State	:	NY
Zip	:	11552-2155
Country	:	US
Telephone Number	:	516-539-7540
Fax Number	:	516-539-7541

Provider Business Practice Location Address
First Line	:	111 HEMPSTEAD TPKE
Second Line	:
City	:	WEST HEMPSTEAD
State	:	NY
Zip	:	11552-2155
Country	:	US
Telephone Number	:	516-539-7540
Fax Number	:	516-539-7541

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. HANA GUROVICHKIN
Credential	:
Telephone Number	:	516-539-7540

Provider Enumeration Date	:	06/12/2014
Last Update Date	:	06/12/2014

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