Healthcare Provider Details
I. General information
NPI: 1386266898
Provider Name (Legal Business Name): LINCOLN NYC RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2020
Last Update Date: 04/30/2024
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2825 3RD AVE
BRONX NY
10455-4066
US
IV. Provider business mailing address
2825 3RD AVE
BRONX NY
10455-4066
US
V. Phone/Fax
- Phone: 917-792-2411
- Fax: 917-792-2414
- Phone: 917-792-2411
- Fax: 917-792-2414
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SALMAN
RIAZ
Title or Position: PRESIDENT
Credential:
Phone: 718-292-7979