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Organization
THIRD AVENUE DRUG CORP
Active
Organization
THIRD AVENUE DRUG CORP
Active
Other names
Rainbow Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE RIVERA (PRESIDENT)
(212) 535-7100
Entity
Organization
Contact information
Practice address
1449 1ST AVE, NEW YORK, NY 10021-3002
(212) 535-7100
(212) 535-7101
Mailing address
1449 1ST AVE, NEW YORK, NY 10021-3002
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
029197
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3359292
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/09/2008
Last updated
06/17/2009
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