Provider Demographics
NPI:1619769494
Name:MERRICK DRUGS RX LLC
Entity type:Organization
Organization Name:MERRICK DRUGS RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMUNOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-928-3323
Mailing Address - Street 1:22711 MERRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2104
Mailing Address - Country:US
Mailing Address - Phone:718-928-3323
Mailing Address - Fax:718-540-7416
Practice Address - Street 1:22711 MERRICK BLVD
Practice Address - Street 2:
Practice Address - City:LAURELTON
Practice Address - State:NY
Practice Address - Zip Code:11413-2104
Practice Address - Country:US
Practice Address - Phone:718-928-3323
Practice Address - Fax:718-540-7416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy