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Organization

MARTIN DRUGS OF RIVERHEAD,INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAJENDRAPRASAD VENIGALLA (PRESIDENT/OWNER)
(347) 528-8893
Entity
Organization

Contact information

Practice address
849 OLD COUNTRY RD, RIVERHEAD, NY 11901-2106
(631) 727-0550
(631) 727-3054
Mailing address
849 OLD COUNTRY RD, RIVERHEAD, NY 11901-2106
(631) 727-0550
(631) 727-3054

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00999440
NY
01
019246
STATE REGISTRATION
NY
Enumeration date
04/24/2023
Last updated
04/24/2023
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