Provider Demographics
NPI:1316920606
Name:RITE-WAY PHARMACY,LLC
Entity type:Organization
Organization Name:RITE-WAY PHARMACY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAILESH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-860-0600
Mailing Address - Street 1:1603 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-2914
Mailing Address - Country:US
Mailing Address - Phone:718-860-0600
Mailing Address - Fax:718-860-6468
Practice Address - Street 1:1603 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-2914
Practice Address - Country:US
Practice Address - Phone:718-860-0600
Practice Address - Fax:718-860-6468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025374333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02245403Medicaid
NY02245403Medicaid