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General NPI Number Information
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NPI Number | 1003335597
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Entity Type | Organization
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Legal Business Name | HILLSIDE RX INC
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 159-22 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-739-7777
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Fax | 718-739-7775
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Provider Business Mailing Address
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Address Line | 15922 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-3936
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Country | US
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Telephone | 718-739-7777
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Fax | 718-739-7775
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Authorized Official
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Title or Position | PRESIDENT
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Name | SULAIMON PRIYEV
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Credential |
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Telephone | 718-739-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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