Healthcare Provider Details

I. General information

NPI: 1689610131
Provider Name (Legal Business Name): USS RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 06/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13407 LIBERTY AVE
SOUTH RICHMOND HILL NY
11419-2354
US

IV. Provider business mailing address

134-07 LIBERTY AVE
RICHMOND HILL NY
11419
US

V. Phone/Fax

Practice location:
  • Phone: 718-206-0716
  • Fax: 718-206-0578
Mailing address:
  • Phone: 718-206-0716
  • Fax: 718-206-0578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number027639
License Number StateNY

VIII. Authorized Official

Name: VISHWANATHAM CHIKOTI
Title or Position: OWNER SUVP PHRM
Credential:
Phone: 718-206-0716