Provider Demographics
NPI:1851875520
Name:CLOVE RX LLC
Entity Type:Organization
Organization Name:CLOVE RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:KHAN
Authorized Official - Last Name:SWATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-920-0633
Mailing Address - Street 1:2062 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1650
Mailing Address - Country:US
Mailing Address - Phone:917-830-1499
Mailing Address - Fax:917-830-1488
Practice Address - Street 1:2062 CLOVE RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-1650
Practice Address - Country:US
Practice Address - Phone:917-830-1499
Practice Address - Fax:917-830-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy