Provider Demographics
NPI:1245079524
Name:COMMUNITY PHARMACY RX INC
Entity type:Organization
Organization Name:COMMUNITY PHARMACY RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:M
Authorized Official - Last Name:EISA
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:201-333-4700
Mailing Address - Street 1:79 MONTICELLO AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2558
Mailing Address - Country:US
Mailing Address - Phone:201-333-4700
Mailing Address - Fax:201-333-4708
Practice Address - Street 1:79 MONTICELLO AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2558
Practice Address - Country:US
Practice Address - Phone:201-333-4700
Practice Address - Fax:201-333-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy