Provider Demographics
NPI:1275257768
Name:PM RX, CORP.
Entity Type:Organization
Organization Name:PM RX, CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIZIEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-935-3224
Mailing Address - Street 1:5325 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4238
Mailing Address - Country:US
Mailing Address - Phone:347-935-3223
Mailing Address - Fax:347-935-3191
Practice Address - Street 1:5325 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4238
Practice Address - Country:US
Practice Address - Phone:347-935-3223
Practice Address - Fax:888-831-2567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy