Healthcare Provider Details

I. General information

NPI: 1346521762
Provider Name (Legal Business Name): MRN DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1262 BOSTON ROAD
BRONX NY
10456
US

IV. Provider business mailing address

1262 BOSTON ROAD
BRONX NY
10456
US

V. Phone/Fax

Practice location:
  • Phone: 347-699-6006
  • Fax: 347-590-5487
Mailing address:
  • Phone: 347-699-6006
  • Fax: 347-590-5487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number030841
License Number StateNY

VIII. Authorized Official

Name: MR. PANAMKADAVETH RAJARAM
Title or Position: V.PRES.
Credential: R.PH
Phone: 347-699-6006