Organization
LIFECARE RX INC.
Active
Other names
Med Script Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDUART BORUKHOV (PRESIDENT)
(718) 658-9300
Entity
Organization
Contact information
Practice address
8342 PARSONS BLVD, JAMAICA, NY 11432-1642
(718) 658-9300
(718) 658-2700
Mailing address
8342 PARSONS BLVD, JAMAICA, NY 11432-1642
(718) 658-9300
(718) 658-2700
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034510
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159669
PK
—
Enumeration date
11/02/2015
Last updated
06/21/2016
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