Organization
LIFELINE RX LLC
Active
Other names
The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
DHARMESH PATEL (PRESIDENT)
(845) 778-6661
Entity
Organization
Contact information
Practice address
38 GRANT ST, WALDEN, NY 12586-1850
(845) 778-6661
(845) 778-6639
Mailing address
38 GRANT ST, WALDEN, NY 12586-1850
(845) 778-6661
(845) 778-6639
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
030268
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127175
PK
—
05
—
3281005
—
NY
Enumeration date
07/06/2010
Last updated
11/06/2013
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