Healthcare Provider Details

I. General information

NPI: 1851489959
Provider Name (Legal Business Name): MASON RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 CASTLE HILL AVE
BRONX NY
10462-4813
US

IV. Provider business mailing address

1255 CASTLE HILL AVE
BRONX NY
10462-4813
US

V. Phone/Fax

Practice location:
  • Phone: 718-863-0210
  • Fax: 718-863-0707
Mailing address:
  • Phone: 718-863-0210
  • Fax: 718-863-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number028777
License Number StateNY

VIII. Authorized Official

Name: MANOJ BAROT
Title or Position: PRESIDENT
Credential: RPH
Phone: 718-860-0210