Provider Demographics
NPI:1427783125
Name:OPRX #11787, LLC
Entity type:Organization
Organization Name:OPRX #11787, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARIT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-876-0737
Mailing Address - Street 1:260 E MIDDLE COUNTRY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2923
Mailing Address - Country:US
Mailing Address - Phone:631-979-7575
Mailing Address - Fax:631-979-2374
Practice Address - Street 1:260 E MIDDLE COUNTRY RD STE 105
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2923
Practice Address - Country:US
Practice Address - Phone:631-979-7575
Practice Address - Fax:631-979-2374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy