Provider Demographics
NPI:1457886574
Name:MJM RX CORP
Entity Type:Organization
Organization Name:MJM RX CORP
Other - Org Name:EXCEL DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-453-1003
Mailing Address - Street 1:42 THOMAS S BOYLAND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-2028
Mailing Address - Country:US
Mailing Address - Phone:718-453-1003
Mailing Address - Fax:718-453-6121
Practice Address - Street 1:42 THOMAS S BOYLAND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-2028
Practice Address - Country:US
Practice Address - Phone:718-453-1003
Practice Address - Fax:718-453-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy