Provider Demographics
NPI:1043600562
Name:DLRX LLC
Entity Type:Organization
Organization Name:DLRX LLC
Other - Org Name:ICARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-777-9677
Mailing Address - Street 1:2256 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6303
Mailing Address - Country:US
Mailing Address - Phone:929-777-9611
Mailing Address - Fax:929-777-9612
Practice Address - Street 1:2256 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6303
Practice Address - Country:US
Practice Address - Phone:929-777-9611
Practice Address - Fax:929-777-9612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0333933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1231A8J3Medicaid
2151780OtherPK