Organization
REX SPECIALTY PHARMACY CORP
Active
Other names
Crescent Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI HASSAN JAFFERY PHARM.D (PRESIDENT/SUPERVISING PHARMACIST)
(516) 593-7747
Entity
Organization
Contact information
Practice address
48 CENTRAL CT, VALLEY STREAM, NY 11580-1143
(516) 593-7747
(516) 593-7094
Mailing address
48 CENTRAL CT, VALLEY STREAM, NY 11580-1143
(516) 593-7747
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
029168
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03047692
—
NY
01
—
3359533
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/03/2008
Last updated
09/14/2021
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