MEDICARE: RIVER PARK 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
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1760991053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER PARK RX LLC

Provider Business Mailing Address
First Line	:	1818 CEDAR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-2706
Country	:	US
Telephone Number	:	347-726-6969
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 CEDAR AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10453-2706
Country	:	US
Telephone Number	:	347-726-6969
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PADMA SANAPATI
Credential	:
Telephone Number	:	347-726-6969

Provider Enumeration Date	:	09/29/2017
Last Update Date	:	03/17/2025

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