Provider Demographics
NPI:1073981346
Name:FAMILY RX PHARMACY INC.
Entity Type:Organization
Organization Name:FAMILY RX PHARMACY INC.
Other - Org Name:FAMILY RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MAKS
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNATANOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:917-650-8559
Mailing Address - Street 1:621 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3740
Mailing Address - Country:US
Mailing Address - Phone:516-280-7474
Mailing Address - Fax:516-280-7475
Practice Address - Street 1:621 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-3740
Practice Address - Country:US
Practice Address - Phone:516-280-7474
Practice Address - Fax:516-280-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033888333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7453150001Medicare NSC