MEDICARE: UNIRX

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
1	333600000X	Pharmacy	30836	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1467506287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIRX

Provider Business Mailing Address
First Line	:	4106 162ND ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-4123
Country	:	US
Telephone Number	:	718-762-7224
Fax Number	:	718-358-1272

Provider Business Practice Location Address
First Line	:	4106 162ND ST
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-4123
Country	:	US
Telephone Number	:	718-762-7224
Fax Number	:	718-358-1272

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT HOPKINS
Credential	:	RPH
Telephone Number	:	718-762-7224

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	11/04/2011

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7161 159TH ST
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1710207766 — KRISTEN GANCHROW
Practice Location Address:

7161 159TH ST
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Directions to “UNIRX ” Practice Location

Language	Start Address	Practice Location

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