Healthcare Provider Details

I. General information

NPI: 1407520042
Provider Name (Legal Business Name): OPRX PHARMACY #10510, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 N STATE RD
BRIARCLIFF MANOR NY
10510-1415
US

IV. Provider business mailing address

89 N STATE RD
BRIARCLIFF MANOR NY
10510-1415
US

V. Phone/Fax

Practice location:
  • Phone: 914-941-1970
  • Fax: 914-941-4381
Mailing address:
  • Phone: 914-941-1970
  • Fax: 914-941-4381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SARIT ROY
Title or Position: CEO
Credential:
Phone: 516-876-0737