Provider Demographics
NPI:1275280547
Name:PURE PHARMA RX INC
Entity Type:Organization
Organization Name:PURE PHARMA RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-932-2650
Mailing Address - Street 1:21333 39TH AVE STE 236
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2092
Mailing Address - Country:US
Mailing Address - Phone:716-932-2650
Mailing Address - Fax:716-932-2651
Practice Address - Street 1:21333 39TH AVE STE 236
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2092
Practice Address - Country:US
Practice Address - Phone:716-932-2650
Practice Address - Fax:716-932-2651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy