Provider Demographics
NPI:1902678857
Name:MOUNT SINAI RX INC
Entity Type:Organization
Organization Name:MOUNT SINAI RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAKOV
Authorized Official - Middle Name:
Authorized Official - Last Name:SULEYMANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-600-8090
Mailing Address - Street 1:19315 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3028
Mailing Address - Country:US
Mailing Address - Phone:818-600-8090
Mailing Address - Fax:
Practice Address - Street 1:19315 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3028
Practice Address - Country:US
Practice Address - Phone:818-600-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy