Provider Demographics
NPI:1891522462
Name:CASCADE RX LLC
Entity type:Organization
Organization Name:CASCADE RX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-500-3307
Mailing Address - Street 1:859 MYRTLE AVE
Mailing Address - Street 2:GROUND FL UNIT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:859 MYRTLE AVE
Practice Address - Street 2:GROUND FL UNIT 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-500-3307
Practice Address - Fax:347-229-1948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy