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General NPI Number Information
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NPI Number | 1851784466
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Entity Type | Organization
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Legal Business Name | MADISON RX PHARMACY INC.
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Dates
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Enumeration Date | 03/07/2015
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 203 MADISON ST
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City | NEW YORK
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State | NY
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Zip | 10002-7581
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Country | US
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Telephone | 646-918-7225
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Fax | 646-682-9216
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Provider Business Mailing Address
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Address Line | 203 MADISON ST
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City | NEW YORK
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State | NY
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Zip | 10002-7581
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Country | US
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Telephone | 646-918-7225
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Fax | 646-682-9216
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Authorized Official
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Title or Position | SUPERVISING PHARMACIST
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Name | MR. VICTOR LI
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Credential | PHARM D
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Telephone | 646-918-7225
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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 | 033427
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License Number State | NY
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