Healthcare Provider Details

I. General information

NPI: 1508203555
Provider Name (Legal Business Name): MEDS DIRECT RX OF NY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 05/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 3RD AVE 10TH FLOOR, SUITE 1000
BROOKLYN NY
11232-1904
US

IV. Provider business mailing address

882 3RD AVE 10TH FLOOR, SUITE 1000
BROOKLYN NY
11232-1904
US

V. Phone/Fax

Practice location:
  • Phone: 718-887-9955
  • Fax: 718-887-9558
Mailing address:
  • Phone: 718-887-9955
  • Fax: 718-887-9558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberIN PROCESS
License Number StateNY

VIII. Authorized Official

Name: BOB SCHWARTZ
Title or Position: OPERATIONS & COMPLIANCE OFFICER
Credential:
Phone: 718-887-9955