Provider Demographics
NPI:1790135192
Name:9330 LLC
Entity Type:Organization
Organization Name:9330 LLC
Other - Org Name:RAPID RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIAMANTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KAKATSOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-880-2821
Mailing Address - Street 1:9330 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5626
Mailing Address - Country:US
Mailing Address - Phone:718-205-5400
Mailing Address - Fax:718-205-5449
Practice Address - Street 1:9330 43RD AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5626
Practice Address - Country:US
Practice Address - Phone:718-205-5400
Practice Address - Fax:718-205-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0003X
NY034732333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160571OtherPK
2160571OtherPK