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General NPI Number Information
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NPI Number | 1366337396
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Entity Type | Organization
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Legal Business Name | HAVERSTRAW RX LLC
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 2 MAIN ST
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City | HAVERSTRAW
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State | NY
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Zip | 10927-1966
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Country | US
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Telephone | 845-553-9900
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Fax | 845-553-9911
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Provider Business Mailing Address
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Address Line | 2 MAIN ST
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City | HAVERSTRAW
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State | NY
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Zip | 10927-1966
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Country | US
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Telephone | 845-553-9900
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Fax | 845-553-9911
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Authorized Official
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Title or Position | MANAGER
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Name | LOKESWARA R KALAKOTI
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Credential |
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Telephone | 845-553-9900
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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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