Provider Demographics
NPI:1558052654
Name:ROCKAWAY SCRIPTS RX INC.
Entity Type:Organization
Organization Name:ROCKAWAY SCRIPTS RX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVRIELOF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-341-0759
Mailing Address - Street 1:353 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-2517
Mailing Address - Country:US
Mailing Address - Phone:516-341-0759
Mailing Address - Fax:516-341-0760
Practice Address - Street 1:353 MERRICK RD
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-2517
Practice Address - Country:US
Practice Address - Phone:516-341-0759
Practice Address - Fax:516-341-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy