Shan Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

023189 Issued in NY

Legal business name

SHAN PHARMACY INC

Doing business as

Sumner Ave Pharmacy

Practice address

103 Sumner Ave
Brooklyn, NY 11206-6940

Phone

(718) 455-7100

Fax

(718) 789-8581

NPI assigned

Jan 8, 2007

Last updated

May 20, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rukmin Persand

Title

Manager and Owner

Phone

(718) 455-7100

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SUMNER AVE PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Khabir Uddin Ahamed

  • Pharmacist
  • Brooklyn, NY
  • NPI 1033431853
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1003964578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 SUMNER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112066940",
            "telephone_number": "718-455-7100",
            "fax_number": "718-789-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SUMNER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112066940",
            "telephone_number": "718-455-7100",
            "fax_number": "718-789-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "PERSAND",
        "authorized_official_first_name": "RUKMIN",
        "authorized_official_title_or_position": "MANAGER AND OWNER",
        "authorized_official_telephone_number": "718-455-7100"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "023189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01706216",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3397797",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUMNER AVE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Saeid Shamsian, MD
• Dilfuza Shamsiddinova
• Sayyora Shamsieva
• Koorosh Shamtoub, DDS
• Ronit Shamuilov, PHARMD
• Zihe Shan, M.D
• Isabel Jo Shanahan
• Elena R Shanberg
• Rikki Blair Shanberg, LMSW
• Colleen Shand

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, 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 May 20, 2010; 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.