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NPI Code Detail

MEDICARE: ALICE RX CORP

MEDICARE: ALICE RX CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12177386OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235626557
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALICE RX CORP
Provider Business Mailing Address
First Line : 231 S 3RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-5601
Country : US
Telephone Number : 718-502-6969
Fax Number : 718-502-6979
Provider Business Practice Location Address
First Line : 231 S 3RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-5601
Country : US
Telephone Number : 718-502-6969
Fax Number : 718-502-6979
Authorized Official
Title or Position : PRESIDENT
Name : AVITAL MULLOKANDOV
Credential :
Telephone Number : 718-502-6969
Provider Enumeration Date : 04/23/2018
Last Update Date : 07/25/2025

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Directions to “ALICE RX CORP ” Practice Location

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