Provider Demographics
NPI:1326713488
Name:EMNICO RX INC
Entity Type:Organization
Organization Name:EMNICO RX INC
Other - Org Name:DORADO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:929-500-6836
Mailing Address - Street 1:1440 FOREST AVE
Mailing Address - Street 2:STORE 5
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-2235
Mailing Address - Country:US
Mailing Address - Phone:631-380-3800
Mailing Address - Fax:631-380-3688
Practice Address - Street 1:1440 FOREST AVE
Practice Address - Street 2:STORE 5
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-2235
Practice Address - Country:US
Practice Address - Phone:631-380-3800
Practice Address - Fax:631-380-3688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy