Provider Demographics
NPI:1376994798
Name:AVK RX INC
Entity type:Organization
Organization Name:AVK RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ARONOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-969-3300
Mailing Address - Street 1:3904 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2915
Mailing Address - Country:US
Mailing Address - Phone:718-484-9810
Mailing Address - Fax:718-484-8773
Practice Address - Street 1:3904 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2915
Practice Address - Country:US
Practice Address - Phone:718-484-9810
Practice Address - Fax:718-484-8773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336S0011X, 333600000X, 3336C0004X
NY0349583336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2164597OtherPK