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General NPI Number Information
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NPI Number | 1164881942
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Entity Type | Organization
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Legal Business Name | RAINA RX LLC
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 1208 ROUTE 300 STE 103
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City | NEWBURGH
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State | NY
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Zip | 12550-5003
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Country | US
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Telephone | 800-810-9274
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Fax |
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Provider Business Mailing Address
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Address Line | 1208 ROUTE 300 SUITE 103
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City | NEWBURGH
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State | NY
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Zip | 12550-5003
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Country | US
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Telephone | 845-275-0816
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Fax | 845-275-0846
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Authorized Official
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Title or Position | COO
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Name | ELVIN MONTANEZ
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Credential | PHARMD
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Telephone | 407-830-8820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 034308
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License Number State | NY
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