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General NPI Number Information
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NPI Number | 1255583928
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Entity Type | Organization
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Legal Business Name | ELMHURST RX INC
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 557 E 169TH ST
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City | BRONX
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State | NY
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Zip | 10456-2625
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Country | US
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Telephone | 347-918-8700
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Fax | 347-918-8701
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Provider Business Mailing Address
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Address Line | 557 E 169TH ST
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City | BRONX
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State | NY
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Zip | 10456-2625
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Country | US
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Telephone | 347-918-8700
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Fax | 347-918-8701
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Authorized Official
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Title or Position | PRESIDENT
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Name | IMRAN KAZMI
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Credential |
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Telephone | 917-449-0086
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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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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 029136
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License Number State | NY
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