Provider Demographics
NPI:1588027098
Name:MED-RX INC
Entity type:Organization
Organization Name:MED-RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IFTIKHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RASHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-312-1048
Mailing Address - Street 1:420 MOTHER GASTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-7618
Mailing Address - Country:US
Mailing Address - Phone:718-213-1048
Mailing Address - Fax:718-312-1049
Practice Address - Street 1:420 MOTHER GASTON BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-7618
Practice Address - Country:US
Practice Address - Phone:718-213-1048
Practice Address - Fax:718-312-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0343063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2159439OtherPK