Provider Demographics
NPI:1508203555
Name:MEDS DIRECT RX OF NY, LLC
Entity Type:Organization
Organization Name:MEDS DIRECT RX OF NY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS & COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-887-9955
Mailing Address - Street 1:882 3RD AVE
Mailing Address - Street 2:10TH FLOOR, SUITE 1000
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1904
Mailing Address - Country:US
Mailing Address - Phone:718-887-9955
Mailing Address - Fax:718-887-9558
Practice Address - Street 1:882 3RD AVE
Practice Address - Street 2:10TH FLOOR, SUITE 1000
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1904
Practice Address - Country:US
Practice Address - Phone:718-887-9955
Practice Address - Fax:718-887-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYIN PROCESS333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy