1578059325 NPI number — MC RX INC.

Table of content: (NPI 1578059325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578059325 NPI number — MC RX INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MC RX INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578059325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 S BEDFORD RD STE 390
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT KISCO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10549-3425
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-361-1260
Provider Business Mailing Address Fax Number:
800-737-4920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 S BEDFORD RD STE 390
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT KISCO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10549-3425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-361-1260
Provider Business Practice Location Address Fax Number:
800-737-4920
Provider Enumeration Date:
07/05/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MIRRA
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
800-361-1260

Provider Taxonomy Codes

  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 036625 . This is a "NYS BOARD OF PHARMAY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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