Provider Demographics
NPI:1154702942
Name:MERGEWELL RX INC
Entity type:Organization
Organization Name:MERGEWELL RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RASIK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHARM D
Authorized Official - Phone:718-638-3800
Mailing Address - Street 1:759 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4504
Mailing Address - Country:US
Mailing Address - Phone:718-638-3800
Mailing Address - Fax:718-638-0239
Practice Address - Street 1:759 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4504
Practice Address - Country:US
Practice Address - Phone:718-638-3800
Practice Address - Fax:718-638-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPENDINGOtherPHARMACY
NYPENDINGOtherPHARMACY