| Organization Name: | MY RX PHARMACY INC |
| NPI Number: | 1083913917 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BORIS KANDOV (OWNER) |
| Mailing Address: | 17815 Union Tpke Fresh Meadows |
| State: | NY US |
| Postal Code: | 113661633 |
| Phone Number: | 7189696979 |
| Fax Number: | 7189694111 |
| NPI Enumeration Date: | 03/17/2011 |
| NPI Last Update Date: | 04/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | 030639 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |