Custom RX Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034366 Issued in NY

Legal business name

CUSTOM RX PHARMACY LLC

Practice address

10203A Queens Blvd
Forest Hills, NY 11375

Phone

(718) 830-4500

Fax

(718) 830-4505

NPI assigned

Mar 23, 2016

Organization subpart

No

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

Authorized official

Name

Albert Pinkhasov, RPH

Title

Pharmacist

Phone

(718) 830-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• customrxpharmacyllc Former legal business name

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Igor Aronov, RPH

  • Pharmacist
  • New York, NY
  • NPI 1154505394
  NPD

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1003278656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10203A QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752857",
            "telephone_number": "718-830-4500",
            "fax_number": "718-830-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10203A QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-830-4500",
            "fax_number": "718-830-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM RX PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "PINKHASOV",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "718-830-4500",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04552214",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "customrxpharmacyllc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Candacie A Cuffy
• Kelianne Elizabeth Cummings, MD
• Patricia Cummings, R.N.
• Brianna Jaylyne Curbelo
• Nicole Curcio
• CVS Albany LLC
• CVS Albany LLC
• CVS Albany LLC
• CVS Albany LLC
• Aurora Czegledi

• Community/Retail Pharmacy in Forest Hills, NY
• Providers in Forest Hills, 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 Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.