Provider Demographics
NPI:1508571258
Name:GLEN OAKS RX INC.
Entity Type:Organization
Organization Name:GLEN OAKS RX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MURATOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-767-1609
Mailing Address - Street 1:1255 150TH ST LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1763
Mailing Address - Country:US
Mailing Address - Phone:718-767-1609
Mailing Address - Fax:718-767-1610
Practice Address - Street 1:1255 150TH ST LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-1763
Practice Address - Country:US
Practice Address - Phone:718-767-1609
Practice Address - Fax:718-767-1610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy