Provider Demographics
NPI:1689400640
Name:MEDI TECH RX LLC
Entity type:Organization
Organization Name:MEDI TECH RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHHIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-533-9700
Mailing Address - Street 1:702 JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1616
Mailing Address - Country:US
Mailing Address - Phone:908-533-9700
Mailing Address - Fax:908-533-9701
Practice Address - Street 1:702 JERSEY AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1616
Practice Address - Country:US
Practice Address - Phone:908-533-9700
Practice Address - Fax:908-533-9701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy