Provider Demographics
NPI:1639369671
Name:STAT RX PHARMACY, INC.
Entity Type:Organization
Organization Name:STAT RX PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-810-9290
Mailing Address - Street 1:235 E 167 ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-4024
Mailing Address - Country:US
Mailing Address - Phone:718-538-4754
Mailing Address - Fax:718-538-4802
Practice Address - Street 1:235 E 167 ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-4024
Practice Address - Country:US
Practice Address - Phone:718-538-4754
Practice Address - Fax:718-538-4802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02902541Medicaid
NY02902541Medicaid