Provider Demographics
NPI:1386644870
Name:RIAAN RX INC
Entity Type:Organization
Organization Name:RIAAN RX INC
Other - Org Name:GARY'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARENDRAKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:201-912-1660
Mailing Address - Street 1:349 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-4004
Mailing Address - Country:US
Mailing Address - Phone:973-667-1003
Mailing Address - Fax:973-667-2282
Practice Address - Street 1:349 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-4004
Practice Address - Country:US
Practice Address - Phone:973-667-1003
Practice Address - Fax:973-667-2282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4274008Medicaid
NJ4274008Medicaid