Organization
MODERN RX LIMITED LIABILITY COMPANY
Active
Other names
Modern Medicine Rx
Organization subpart
No
Provider details
NPI number
Authorized official
KLARA REIZIS (OWNER)
(201) 420-9000
Entity
Organization
Contact information
Practice address
56 CHAMBERS BRIDGE RD STE 8, BRICK, NJ 08723-4148
(732) 475-7593
(732) 903-7402
Mailing address
56 CHAMBERSBRIDGE ROAD SUITE 8, BRICK, NJ 08723
(732) 475-7593
(732) 903-7402
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00756700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2169830
PK
—
Enumeration date
06/18/2017
Last updated
06/18/2017
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