MEDICARE: HOSP. RX, INC.

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	017511	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	:	1568467710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSP. RX, INC.

Provider Business Mailing Address
First Line	:	759 WASHINGTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-4504
Country	:	US
Telephone Number	:	718-638-3800
Fax Number	:	718-638-0239

Provider Business Practice Location Address
First Line	:	759 WASHINGTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-4504
Country	:	US
Telephone Number	:	718-638-3800
Fax Number	:	718-638-0239

Authorized Official
Title or Position	:	CORPORATE SECRETARY
Name	:	ALEX PERCHUK
Credential	:	RPH
Telephone Number	:	718-835-2000

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	06/24/2008

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