Organization
MODERN RX LIMITED LIABILITY COMPANY
Active
Other names
Modern Medicine Rx
Organization subpart
No
Provider details
NPI number
Authorized official
KLARA REIZIS (OWNER/PHARMACIST/AO)
(917) 217-3908
Entity
Organization
Contact information
Practice address
33-41 NEWARK ST STE 2B, HOBOKEN, NJ 07030-5620
(201) 420-9000
(201) 420-4040
Mailing address
33-41 NEWARK ST STE 2B, HOBOKEN, NJ 07030-5620
(201) 420-9000
(201) 420-4040
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
28RS00733400
NJ
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0436755
—
NJ
01
—
2146077
PK
—
Enumeration date
06/02/2014
Last updated
04/27/2020
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