Organization
RIVERSIDE SRX INC
Active
Other names
Riverside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VAMSIDHAR VASIREDDY (PRESIDENT)
(212) 491-5500
Entity
Organization
Contact information
Practice address
2920 FREDERICK DOUGLASS BLVD, NEW YORK, NY 10039-1610
(212) 491-5500
(212) 491-5501
Mailing address
2920 FREDERICK DOUGLASS BLVD, NEW YORK, NY 10039-1610
(212) 491-5500
(212) 491-5501
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
030384
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5801724
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/09/2010
Last updated
09/01/2020
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