Provider Demographics
NPI:1093943185
Name:R.M.R. PHARMACY INC.
Entity Type:Organization
Organization Name:R.M.R. PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-448-6965
Mailing Address - Street 1:6508 ROOSEVELT AVE
Mailing Address - Street 2:WOODSIDE
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2928
Mailing Address - Country:US
Mailing Address - Phone:347-448-6965
Mailing Address - Fax:
Practice Address - Street 1:6508 ROOSEVELT AVE
Practice Address - Street 2:WOODSIDE
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2928
Practice Address - Country:US
Practice Address - Phone:347-448-6965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-26
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0295163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6338610001Medicare NSC