Provider Demographics
NPI:1457923864
Name:MELROSE PHARMA INC
Entity Type:Organization
Organization Name:MELROSE PHARMA INC
Other - Org Name:MELROSE SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARIDAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUVAGIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-571-3091
Mailing Address - Street 1:666 COURTLANDT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:666 COURTLANDT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5018
Practice Address - Country:US
Practice Address - Phone:862-571-3091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy