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NPI Code Detail

MEDICARE: GREEN PHARMACY RX LLC

MEDICARE: GREEN PHARMACY RX LLC
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
13336S0011XSpecialty Pharmacy
23336C0003XCommunity/Retail Pharmacy
3333600000XPharmacy

General Provider Information

NPI Number : 1285566950
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREEN PHARMACY RX LLC
Provider Business Mailing Address
First Line : 133 DREISER LOOP
Second Line :
City : BRONX
State : NY
Zip : 10475-2704
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 133 DREISER LOOP
Second Line :
City : BRONX
State : NY
Zip : 10475-2704
Country : US
Telephone Number : 718-513-5889
Fax Number :
Authorized Official
Title or Position : PIC
Name : COREEN MARKLAND
Credential :
Telephone Number : 718-513-5889
Provider Enumeration Date : 05/29/2026
Last Update Date : 05/29/2026

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Directions to “GREEN PHARMACY RX LLC ” Practice Location

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