Organization · NPI-2

63rd Rx Corp.

Pharmacy · Rego Park, NY

NPI number1639819444

StatusActive

Last updated in NPPESOct 23, 2023

Details

NPI: 1639819444
Entity type: Organization (NPI-2)
Legal business name: 63rd Rx Corp.
Organization subpart: No
Enumeration date: Mar 30, 2022
Certification date: Oct 23, 2023
Last updated: Oct 23, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
333600000X	Pharmacy	–	–	Yes
332B00000X	Durable Medical Equipment & Medical Supplies	–	–

Practice location

9855 63rd Rd
Rego Park, NY 11374-1739

Phone 718-897-4747 · Fax 718-897-4748

Mailing address

9855 63rd Rd
Rego Park, NY 11374-1739

Phone 718-897-4747 · Fax 718-897-4748

Authorized official

Michael Kakzanov
President
7188974747

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