Provider Demographics
NPI:1316573876
Name:BRIARWOOD RX INC
Entity Type:Organization
Organization Name:BRIARWOOD RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-679-2765
Mailing Address - Street 1:8515 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1879
Mailing Address - Country:US
Mailing Address - Phone:347-475-0722
Mailing Address - Fax:516-408-3992
Practice Address - Street 1:8515 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-1879
Practice Address - Country:US
Practice Address - Phone:347-475-0722
Practice Address - Fax:516-408-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy