Provider Demographics
NPI:1841611506
Name:BROOKDALE RX INC
Entity Type:Organization
Organization Name:BROOKDALE RX INC
Other - Org Name:URGENT CARE RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-923-0685
Mailing Address - Street 1:1235 LINDEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:718-240-8388
Mailing Address - Fax:917-947-8507
Practice Address - Street 1:1235 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-8388
Practice Address - Fax:917-947-8507
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKDALERX, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-26
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy