Healthcare Provider Details

I. General information

NPI: 1710005822
Provider Name (Legal Business Name): TAP RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 S SERVICE RD STE 25
MELVILLE NY
11747-2399
US

IV. Provider business mailing address

1 OLYMPIC PL STE 600
TOWSON MD
21204-4110
US

V. Phone/Fax

Practice location:
  • Phone: 631-843-0500
  • Fax: 631-843-0500
Mailing address:
  • Phone: 888-741-0367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number028192
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number028192
License Number StateNY

VIII. Authorized Official

Name: DR. BINCY VARGHESE
Title or Position: DIRECTOR OF COMPLIANCE
Credential: PHARM D
Phone: 888-741-0367