Healthcare Provider Details

I. General information

NPI: 1790224004
Provider Name (Legal Business Name): PAY RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 W 207TH ST
NEW YORK NY
10034-2607
US

IV. Provider business mailing address

567 W 207TH ST
NEW YORK NY
10034-2607
US

V. Phone/Fax

Practice location:
  • Phone: 212-544-0020
  • Fax: 212-544-0122
Mailing address:
  • Phone: 212-544-0020
  • Fax: 212-544-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. FAROOQ KHALID
Title or Position: PRESIDENT
Credential:
Phone: 201-982-5897