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General NPI Number Information
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NPI Number | 1609632132
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Entity Type | Organization
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Legal Business Name | MADISON RX 18 INC.
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 4718 30TH AVE
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City | ASTORIA
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State | NY
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Zip | 11103-1266
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Country | US
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Telephone | 718-806-1000
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Fax | 718-806-1115
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Provider Business Mailing Address
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Address Line | 4718 30TH AVE
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City | ASTORIA
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State | NY
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Zip | 11103-1266
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Country | US
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Telephone | 718-806-1000
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Fax | 718-806-1115
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | DR. MOSHE COHEN
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Credential |
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Telephone | 718-806-1000
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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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