Provider Demographics
NPI:1649022591
Name:UNIQUE PHARMACY RX LLC
Entity type:Organization
Organization Name:UNIQUE PHARMACY RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAMOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-785-6717
Mailing Address - Street 1:401 DITMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4919
Mailing Address - Country:US
Mailing Address - Phone:718-484-0899
Mailing Address - Fax:
Practice Address - Street 1:401 DITMAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4919
Practice Address - Country:US
Practice Address - Phone:718-484-0899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy