Provider Demographics
NPI:1417844747
Name:TOTAL MED RX 214 INC
Entity type:Organization
Organization Name:TOTAL MED RX 214 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIDIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARIZHAPOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-894-8011
Mailing Address - Street 1:21485 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-1737
Mailing Address - Country:US
Mailing Address - Phone:347-894-8011
Mailing Address - Fax:347-894-8025
Practice Address - Street 1:21485 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-1737
Practice Address - Country:US
Practice Address - Phone:347-894-8011
Practice Address - Fax:347-894-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy