Healthcare Provider Details

I. General information

NPI: 1801162375
Provider Name (Legal Business Name): EVERS RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 E 144TH ST FL 2
BRONX NY
10451-5909
US

IV. Provider business mailing address

226 E 144TH ST FL 2
BRONX NY
10451-5909
US

V. Phone/Fax

Practice location:
  • Phone: 718-292-0900
  • Fax: 718-292-0909
Mailing address:
  • Phone: 718-292-0900
  • Fax: 718-292-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number031260
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVE WATTS
Title or Position: VICE PRESIDENT
Credential: PHARM D
Phone: 718-292-0900