Healthcare Provider Details

I. General information

NPI: 1326250341
Provider Name (Legal Business Name): RAILROAD RX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 04/03/2022
Certification Date: 04/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W RAILROAD AVE
GARNERVILLE NY
10923-1243
US

IV. Provider business mailing address

150 W RAILROAD AVE
GARNERVILLE NY
10923-1243
US

V. Phone/Fax

Practice location:
  • Phone: 845-429-5075
  • Fax: 845-429-5676
Mailing address:
  • Phone: 845-429-5075
  • Fax: 845-429-5676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number24799
License Number StateNY

VIII. Authorized Official

Name: BRADLEY DEANE BREEDING
Title or Position: PRESIDENT/SUPERVISING PHARMACIST
Credential: RPH
Phone: 845-429-5075