MEDICARE: COMMUNITY 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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	040480	OTHER	NY	BOARD LICENSE

General Provider Information

NPI Number	:	1760164032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY RX INC

Provider Business Mailing Address
First Line	:	1056 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2303
Country	:	US
Telephone Number	:	718-421-5533
Fax Number	:	718-421-7440

Provider Business Practice Location Address
First Line	:	1056 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2303
Country	:	US
Telephone Number	:	718-421-5533
Fax Number	:	718-421-7440

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MUHAMMAD QASIM ANWAR
Credential	:
Telephone Number	:	718-421-5533

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	09/14/2023

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Directions to “COMMUNITY RX INC ” Practice Location

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