Provider Demographics
NPI:1750150504
Name:OCEAN SPECIALTY RX INC.
Entity type:Organization
Organization Name:OCEAN SPECIALTY RX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ITZHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:TATOLOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-431-8232
Mailing Address - Street 1:128 DITMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4902
Mailing Address - Country:US
Mailing Address - Phone:718-431-8232
Mailing Address - Fax:718-431-8253
Practice Address - Street 1:128 DITMAS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4902
Practice Address - Country:US
Practice Address - Phone:718-431-8232
Practice Address - Fax:718-431-8253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-21
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039331OtherSTATE BOARD