Provider Demographics
NPI:1568467710
Name:HOSP. RX, INC.
Entity Type:Organization
Organization Name:HOSP. RX, INC.
Other - Org Name:THRIFTWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-835-2000
Mailing Address - Street 1:759 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4504
Mailing Address - Country:US
Mailing Address - Phone:718-638-3800
Mailing Address - Fax:718-638-0239
Practice Address - Street 1:759 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4504
Practice Address - Country:US
Practice Address - Phone:718-638-3800
Practice Address - Fax:718-638-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017511333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02376709Medicaid
NY02376709Medicaid