Provider Demographics
NPI:1255503744
Name:MEDSRUS PHARMACY, INC
Entity Type:Organization
Organization Name:MEDSRUS PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-378-1200
Mailing Address - Street 1:932 E 174TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-5202
Mailing Address - Country:US
Mailing Address - Phone:718-378-1200
Mailing Address - Fax:718-378-1300
Practice Address - Street 1:932 E 174TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5202
Practice Address - Country:US
Practice Address - Phone:718-378-1200
Practice Address - Fax:718-378-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0287933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy