Healthcare Provider Details

I. General information

NPI: 1891688305
Provider Name (Legal Business Name): 161 ST PHARMA RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 E 161ST ST
BRONX NY
10451-3504
US

IV. Provider business mailing address

275 E 161ST ST
BRONX NY
10451-3504
US

V. Phone/Fax

Practice location:
  • Phone: 718-742-3400
  • Fax: 718-742-3416
Mailing address:
  • Phone: 718-742-3400
  • Fax: 718-742-3416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MANOJKUMAR SHAH
Title or Position: PRESIDENT
Credential:
Phone: 718-742-3400