Mirra RX Inc

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

License

030332 Issued in NY

Legal business name

MIRRA RX INC

Practice address

14 Madison Ave
Valhalla, NY 10595-1900

Phone

(800) 361-1260

NPI assigned

Dec 14, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Dominick Mirra, RPH

Title

President

Phone

(914) 980-8321

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cornerstone Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1902109952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MADISON AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951900",
            "telephone_number": "800-361-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MADISON AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951900",
            "telephone_number": "800-361-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRRA RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "MIRRA",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "DOMINICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-980-8321",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NY",
            "license": "030332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS PHARMACY REGISTRATION",
            "identifier": "030332",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca C Miller
• Roy Miller
• Konstantin Millerman, MD
• Danail Minev, NP
• Pamela Mintzer
• Yakira Pnina Mishan, MD
• Carmina Harina Mislang, M.D.
• Milicent Mitchell, M.D.
• Tyra G Mitchell
• Rami Mizher, MD

• Specialty Pharmacy in Valhalla, NY
• Providers in Valhalla, NY by specialty
• Specialty Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.