Organization
LIFETIME RX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANI KANDOV (OWNER)
(718) 889-6866
Entity
Organization
Contact information
Practice address
3222 STEINWAY ST, ASTORIA, NY 11103-4006
(718) 889-6866
(718) 889-7385
Mailing address
3222 STEINWAY ST, ASTORIA, NY 11103-4006
(718) 889-6866
(718) 889-7385
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040045
STATE BOARD
NY
Enumeration date
03/16/2023
Last updated
08/29/2023
About Stedi
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