Organization
LIFELINE RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALKIYEL DAVYDOV (MANAGING MEMBER)
(201) 624-8015
Entity
Organization
Contact information
Practice address
5408 PARK AVE, WEST NEW YORK, NJ 07093-3517
(201) 624-8015
(201) 624-8016
Mailing address
5408 PARK AVE, WEST NEW YORK, NJ 07093-3517
(201) 624-8015
(201) 624-8016
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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