MEDICARE: MIG-RX CORP

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

General Provider Information

NPI Number	:	1578405817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIG-RX CORP

Provider Business Mailing Address
First Line	:	1811 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1307
Country	:	US
Telephone Number	:	718-382-9999
Fax Number	:	718-382-9988

Provider Business Practice Location Address
First Line	:	1811 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1307
Country	:	US
Telephone Number	:	718-382-9999
Fax Number	:	718-382-9988

Authorized Official
Title or Position	:	OWNER
Name	:	GENNADY KUPERSHMIDT
Credential	:
Telephone Number	:	718-382-9999

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “MIG-RX CORP ” Practice Location

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