Provider Demographics
NPI:1316545361
Name:MADISON RX INC
Entity Type:Organization
Organization Name:MADISON RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:BUSSOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-295-0700
Mailing Address - Street 1:1701 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3698
Mailing Address - Country:US
Mailing Address - Phone:929-295-0700
Mailing Address - Fax:929-295-0699
Practice Address - Street 1:1701 MADISON ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-3698
Practice Address - Country:US
Practice Address - Phone:929-295-0700
Practice Address - Fax:929-295-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy