Healthcare Provider Details

I. General information

NPI: 1346283520
Provider Name (Legal Business Name): AFFORDABLE RX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 ROCKAWAY AVE
VALLEY STREAM NY
11580-5823
US

IV. Provider business mailing address

177 ROCKAWAY AVE
VALLEY STREAM NY
11580-5823
US

V. Phone/Fax

Practice location:
  • Phone: 516-561-6480
  • Fax: 516-561-6483
Mailing address:
  • Phone: 516-561-6480
  • Fax: 516-561-6483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number034684
License Number StateNY

VIII. Authorized Official

Name: ROBERT S CAPPA
Title or Position: PRESIDENT, TREASURER, SECRETARY
Credential:
Phone: 484-494-3121