# REX SPECIALTY PHARMACY CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Crescent Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649415704
- **Authorized official:** DR. ALI HASSAN JAFFERY PHARM.D (PRESIDENT/SUPERVISING PHARMACIST)
- **Authorized official phone:** (516) 593-7747

## Contact information

- **Practice address:** 48 CENTRAL CT, VALLEY STREAM, NY 11580-1143
- **Practice address phone:** (516) 593-7747
- **Practice address fax:** (516) 593-7094
- **Mailing address:** 48 CENTRAL CT, VALLEY STREAM, NY 11580-1143
- **Mailing address phone:** (516) 593-7747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | 029168 | NY | — |

## Other

- **Enumeration date:** 12/03/2008
- **Last updated:** 09/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03047692 | — | NY |
| 01 | — | 3359533 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |