Provider Demographics
NPI:1326654054
Name:EXPANDRX INC
Entity Type:Organization
Organization Name:EXPANDRX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBASIONWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-400-9144
Mailing Address - Street 1:PO BOX 70779
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-0779
Mailing Address - Country:US
Mailing Address - Phone:718-400-9144
Mailing Address - Fax:718-400-9146
Practice Address - Street 1:2610 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2415
Practice Address - Country:US
Practice Address - Phone:718-400-9144
Practice Address - Fax:718-400-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy