=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962293423
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARCTIC RX INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/14/2025
-----------------------------------------------------
Last Update Date | 05/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18017 JAMAICA AVE
-----------------------------------------------------
City | JAMAICA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11432-5620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-562-2375
-----------------------------------------------------
Fax | 347-584-4796
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18017 JAMAICA AVE
-----------------------------------------------------
City | JAMAICA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11432-5620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-562-2375
-----------------------------------------------------
Fax | 347-584-4796
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | AARON I. ISACOV
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 347-562-2375
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------