# FREEPORT RX INC

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

## Provider details

- **NPI number:** 1730975681
- **Authorized official:** DIANA KHAIMOVA (PRESIDENT)
- **Authorized official phone:** (646) 352-0151

## Contact information

- **Practice address:** 132 W SUNRISE HWY, FREEPORT, NY 11520-3521
- **Practice address phone:** (646) 352-0151
- **Practice address fax:** (646) 352-0116
- **Mailing address:** 132 W SUNRISE HWY, FREEPORT, NY 11520-3521
- **Mailing address phone:** (646) 352-0151
- **Mailing address fax:** (646) 352-0116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/17/2025
- **Last updated:** 04/17/2025