# MARTIN DRUGS OF RIVERHEAD,INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053308684
- **Authorized official:** MR. RAJENDRAPRASAD VENIGALLA RPH (OWNER PRES)
- **Authorized official phone:** (347) 528-8893

## Contact information

- **Practice address:** 849 OLD COUNTRY RD, RIVERHEAD, NY 11901-2106
- **Practice address phone:** (631) 727-0550
- **Practice address fax:** (631) 727-3054
- **Mailing address:** 849 OLD COUNTRY RD, RIVERHEAD, NY 11901-2106
- **Mailing address phone:** (631) 727-0550
- **Mailing address fax:** (631) 727-3054

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 019246 | NY | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/29/2005
- **Last updated:** 04/13/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00999440 | — | NY |
| 01 | — | 019246 | STATE REGISTRATION | NY |
| 01 | — | 33-43340 | NCPDP | — |