Provider Demographics
NPI:1558422238
Name:RSVMDRUGS
Entity Type:Organization
Organization Name:RSVMDRUGS
Other - Org Name:BIRITDRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:S.PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CHINNASAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEETHARAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:718-436-8239
Mailing Address - Street 1:4013-5 AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232
Mailing Address - Country:US
Mailing Address - Phone:718-436-8239
Mailing Address - Fax:718-436-8240
Practice Address - Street 1:4013 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232
Practice Address - Country:US
Practice Address - Phone:718-436-8239
Practice Address - Fax:718-436-8240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017895333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00792989Medicaid
NY1558422238Medicare NSC