Organization
CORAM RX LTD
Active
Other names
PRESCRIPTION CENTRE
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MAHON (PRESIDENT)
(631) 698-2868
Entity
Organization
Contact information
Practice address
35H MIDDLE COUNTRY RD H, CORAM, NY 11727-4404
(631) 698-2868
(631) 698-0119
Mailing address
35H MIDDLE COUNTRY RD H, CORAM, NY 11727-4404
(631) 698-2868
(631) 698-0119
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021599
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2064982
PK
—
05
—
2995302
—
NY
Enumeration date
03/09/2007
Last updated
09/09/2013
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