Provider Demographics
NPI:1326770132
Name:CXR HOSPITALITY, LLC
Entity Type:Organization
Organization Name:CXR HOSPITALITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRUSTEE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-749-0445
Mailing Address - Street 1:PO BOX 1046
Mailing Address - Street 2:
Mailing Address - City:SHELTER ISLAND HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11965-1046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SHELTER ISLAND HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11965-2000
Practice Address - Country:US
Practice Address - Phone:631-749-0445
Practice Address - Fax:631-749-0649
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CXR HOSPITALITY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-29
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy