MLK RX Group LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

032468 Issued in NY

Legal business name

MLK RX GROUP LLC

Practice address

2260 Crotona Ave
Bronx, NY 10457-1939

Phone

(917) 801-2325

Fax

(917) 801-2326

NPI assigned

Jan 8, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mohamad Kourani

Title

Manager

Phone

(973) 277-2237

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Caremore Rx Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohamad-Louai Kourani, PHARMD

  • Pharmacist
  • Passaic, NJ
  • NPI 1134410343
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1679995708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 CROTONA AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571939",
            "telephone_number": "917-801-2325",
            "fax_number": "917-801-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 CROTONA AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571939",
            "telephone_number": "917-801-2325",
            "fax_number": "917-801-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLK RX GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "KOURANI",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-277-2237"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "032468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143812",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03868155",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caremore Rx Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sheera Mizrahi, DMD
• Reina Joy Mizukoshi
• MJM Pharmacy Inc
• Katerina Mlejnkova
• MLK RX Group LLC
• Sarah Eagle Keenan Mlynarczyk, ATR, LCAT
• Eva Dagmara Mlynaryk, PA-C
• MMC Advanced Imaging
• MMC Advanced Imaging
• MMC Astor Avenue Practice

• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.