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General NPI Number Information
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NPI Number | 1316673536
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Entity Type | Organization
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Legal Business Name | OPRX #11565, LLC
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 247 HEMPSTEAD AVE
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City | MALVERNE
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State | NY
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Zip | 11565-2034
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Country | US
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Telephone | 516-593-8663
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Fax | 516-599-8356
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Provider Business Mailing Address
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Address Line | 247 HEMPSTEAD AVE
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City | MALVERNE
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State | NY
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Zip | 11565-2034
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Country | US
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Telephone | 516-593-8663
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Fax | 516-599-8356
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Authorized Official
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Title or Position | PRESIDENT
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Name | SARIT ROY
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Credential |
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Telephone | 516-876-0737
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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 | 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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