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General NPI Number Information
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NPI Number | 1366595852
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Entity Type | Organization
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Legal Business Name | RX DRUG CORP
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 410 LAKEVILLE RD SUITE 102
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1101
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Country | US
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Telephone | 516-352-2337
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Fax | 516-775-0595
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Provider Business Mailing Address
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Address Line | 3 MACKAY WAY
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City | ROSLYN
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State | NY
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Zip | 11576-2175
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Country | US
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Telephone | 516-448-8053
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Fax | 516-775-0595
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Authorized Official
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Title or Position | OWNER
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Name | CHET SHAH
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Credential |
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Telephone | 516-352-2337
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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 | 025343
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License Number State | NY
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