Provider Demographics
NPI:1689052466
Name:ERX PHARMACEUTICAL LLC
Entity Type:Organization
Organization Name:ERX PHARMACEUTICAL LLC
Other - Org Name:QWIKMEDS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-443-0500
Mailing Address - Street 1:159 RALPH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1531
Mailing Address - Country:US
Mailing Address - Phone:718-443-0500
Mailing Address - Fax:718-443-0501
Practice Address - Street 1:159 RALPH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1531
Practice Address - Country:US
Practice Address - Phone:718-443-0500
Practice Address - Fax:718-443-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0335243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy