Provider Demographics
NPI:1750405692
Name:RUPAL ENTERPRISES,INC.
Entity type:Organization
Organization Name:RUPAL ENTERPRISES,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,SUP PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GOVINDDAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:AKRUWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RPH
Authorized Official - Phone:631-732-1223
Mailing Address - Street 1:1224 B MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2524
Mailing Address - Country:US
Mailing Address - Phone:631-732-1223
Mailing Address - Fax:631-732-1224
Practice Address - Street 1:1224 B MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2524
Practice Address - Country:US
Practice Address - Phone:631-732-1223
Practice Address - Fax:631-732-1224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-17
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018802332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00940267Medicaid
NY00940267Medicaid