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General NPI Number Information
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NPI Number | 1962326546
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Entity Type | Organization
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Legal Business Name | PORTWASH RX INC
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 664 PORT WASHINGTON BLVD
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3734
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Country | US
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Telephone | 516-998-1247
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Fax | 516-998-1246
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Provider Business Mailing Address
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Address Line | 664 PORT WASHINGTON BLVD
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-3734
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Country | US
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Telephone | 516-998-1247
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Fax | 516-998-1246
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Authorized Official
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Title or Position | OWNER
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Name | SHAN ASIF
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Credential |
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Telephone | 551-482-3920
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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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