Organization
HMB IV PHARMACY MANAGEMENT LLC
Active
Other names
Metcare Rx
Organization subpart
No
Provider details
NPI number
Authorized official
RAJ SHAH (MANAGER)
(732) 318-9628
Entity
Organization
Contact information
Practice address
1250 WATERS PL, TOWER II, BRONX, NY 10461-2720
(718) 975-7774
(718) 975-7776
Mailing address
1250 WATERS PL, TOWER II, BRONX, NY 10461-2720
(718) 975-7774
(718) 975-7776
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034577
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160312
PK
—
05
—
4752549
—
NY
01
—
7602020001
MEDICARE
NY
Enumeration date
05/24/2016
Last updated
04/04/2022
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