Provider Demographics
NPI:1275333692
Name:BREWSTER RX LLC
Entity type:Organization
Organization Name:BREWSTER RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOKESWARA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KALAKOTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-278-8200
Mailing Address - Street 1:2505 CARMEL AVE STE 111-112
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1155
Mailing Address - Country:US
Mailing Address - Phone:845-278-8200
Mailing Address - Fax:845-278-4340
Practice Address - Street 1:2505 CARMEL AVE STE 111-112
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-1155
Practice Address - Country:US
Practice Address - Phone:845-278-8200
Practice Address - Fax:845-278-4340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041289OtherLICENSE