Healthcare Provider Details

I. General information

NPI: 1407787161
Provider Name (Legal Business Name): GM BH RX INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 W MERRICK RD
FREEPORT NY
11520-3743
US

IV. Provider business mailing address

155 W MERRICK RD
FREEPORT NY
11520-3743
US

V. Phone/Fax

Practice location:
  • Phone: 516-444-4018
  • Fax: 516-444-4019
Mailing address:
  • Phone: 516-444-4018
  • Fax: 516-444-4019

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: FISHEL GOLDSTEIN
Title or Position: PRESIDENT
Credential:
Phone: 516-444-4018