Provider Demographics
NPI:1174102362
Name:MODERN RX PHARMACY INC
Entity type:Organization
Organization Name:MODERN RX PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-553-2211
Mailing Address - Street 1:6298 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3345
Mailing Address - Country:US
Mailing Address - Phone:929-553-2211
Mailing Address - Fax:929-553-2212
Practice Address - Street 1:6298 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3345
Practice Address - Country:US
Practice Address - Phone:929-553-2211
Practice Address - Fax:929-553-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy