Healthcare Provider Details

I. General information

NPI: 1275787509
Provider Name (Legal Business Name): DMS RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

772 GRAND ST
BROOKLYN NY
11211-5395
US

IV. Provider business mailing address

772 GRAND ST
BROOKLYN NY
11211-5395
US

V. Phone/Fax

Practice location:
  • Phone: 718-486-0344
  • Fax: 718-486-0345
Mailing address:
  • Phone: 718-486-0344
  • Fax: 718-486-0345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number029152
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAVI PANCHAL
Title or Position: SUPERVISING PHARMACIST
Credential: RPH
Phone: 718-486-0344