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General NPI Number Information
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NPI Number | 1437482569
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Entity Type | Organization
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Legal Business Name | 158 RX CORP
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Dates
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Enumeration Date | 09/08/2009
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 11 EDWARD MORGAN PL
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-234-1800
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Fax | 212-234-6337
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Provider Business Mailing Address
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Address Line | 1400 AVENUE Z STE 404
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City | BROOKLYN
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State | NY
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Zip | 11235-3837
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Country | US
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Telephone | 718-484-9640
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Fax | 718-484-9644
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELAN KATZ
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Credential |
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Telephone | 718-484-9640
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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 | 029684
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License Number State | NY
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