Provider Demographics
NPI:1487438685
Name:KELMMRX INC
Entity type:Organization
Organization Name:KELMMRX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-551-5110
Mailing Address - Street 1:2202 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3648
Mailing Address - Country:US
Mailing Address - Phone:631-551-5110
Mailing Address - Fax:718-616-0803
Practice Address - Street 1:2202 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3648
Practice Address - Country:US
Practice Address - Phone:631-551-5110
Practice Address - Fax:718-616-0803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy