| NPI | 1992443303 |
|---|---|
| Doing Business As | MADISON RX |
| Entity Type | Organization |
| Authorized Contact | GABRIEL POLTIELOV President 929-219-2575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-05-25 |