Healthcare Provider Details

I. General information

NPI: 1457213936
Provider Name (Legal Business Name): CLEVER MEDS RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20503 JAMAICA AVE
HOLLIS NY
11423-3039
US

IV. Provider business mailing address

20503 JAMAICA AVE
HOLLIS NY
11423-3039
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-2555
  • Fax: 718-470-2031
Mailing address:
  • Phone: 718-470-2555
  • Fax: 718-470-2031

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: DANIEL COHEN
Title or Position: PRESIDENT
Credential:
Phone: 718-470-2555