Provider Demographics
NPI:1932641339
Name:FAR ROCKAWAY DRUGS INC.
Entity Type:Organization
Organization Name:FAR ROCKAWAY DRUGS INC.
Other - Org Name:STRIP RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHVARTSSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-471-2500
Mailing Address - Street 1:1727 SEAGIRT BLVD
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4513
Mailing Address - Country:US
Mailing Address - Phone:888-887-8747
Mailing Address - Fax:718-471-0840
Practice Address - Street 1:1727 SEAGIRT BLVD
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4513
Practice Address - Country:US
Practice Address - Phone:888-887-8747
Practice Address - Fax:718-471-0840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 291U00000X
NY0273663336L0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166221OtherPK
NY33D2204084OtherLIMITED SERVICE LABORATORY