Provider Demographics
NPI:1578382008
Name:MAPLE RX LLC
Entity type:Organization
Organization Name:MAPLE RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:WERZBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-371-6464
Mailing Address - Street 1:382 ROUTE 59 STE 276
Mailing Address - Street 2:
Mailing Address - City:AIRMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 HILLSIDE BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3148
Practice Address - Country:US
Practice Address - Phone:732-370-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAPLE RX LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy