Provider Demographics
NPI:1710304258
Name:VALRX PHARMACY INC
Entity Type:Organization
Organization Name:VALRX PHARMACY INC
Other - Org Name:VALRX PHARMACY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARQAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-484-7045
Mailing Address - Street 1:3007 FARRAGUT RD # 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-1537
Mailing Address - Country:US
Mailing Address - Phone:718-484-7045
Mailing Address - Fax:718-484-7049
Practice Address - Street 1:3007 FARRAGUT RD # 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-1537
Practice Address - Country:US
Practice Address - Phone:718-484-7045
Practice Address - Fax:718-484-7049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-22
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0327573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04047949Medicaid
2145874OtherPK