Provider Demographics
NPI:1356971774
Name:CENTRAL RX PHARMACY CORP
Entity type:Organization
Organization Name:CENTRAL RX PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:NATANOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:917-575-2728
Mailing Address - Street 1:15316 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3128
Mailing Address - Country:US
Mailing Address - Phone:917-575-2728
Mailing Address - Fax:718-223-4594
Practice Address - Street 1:13850 84TH DR
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-1840
Practice Address - Country:US
Practice Address - Phone:718-223-4593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy