Provider Demographics
NPI:1629563465
Name:PERSONALIZED PRESCRIPTIONS INC.
Entity Type:Organization
Organization Name:PERSONALIZED PRESCRIPTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WIESLAW
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOWRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-940-8880
Mailing Address - Street 1:60 E INDUSTRY CT STE 4B
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-4728
Mailing Address - Country:US
Mailing Address - Phone:631-940-8880
Mailing Address - Fax:631-940-8770
Practice Address - Street 1:60 E INDUSTRY CT STE 4B
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-4728
Practice Address - Country:US
Practice Address - Phone:631-940-8880
Practice Address - Fax:631-940-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0366673336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy