909 Columbus RX Ny LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

909 COLUMBUS RX NY LLC

Practice address

909 Columbus Ave
New York, NY 10025-4041

Phone

(212) 222-6388

Fax

(646) 386-7656

NPI assigned

Nov 17, 2008

Organization subpart

No

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

Authorized official

Name

Julia Kravtsova

Title

Pic

Phone

(917) 830-2522

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Quick Rx Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• 909 Columbus RX Ny LLC

  • Long Term Care Pharmacy
  • New York, NY
  • NPI 1215551593

  8325454515

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• 909 Columbus RX Ny LLC

  • Long Term Care Pharmacy
  • New York, NY
  • NPI 1215551593

  O20210316000846

  Same enrollment

Tax ID family

909 Columbus RX Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• 909 Columbus RX Ny LLC

  • Long Term Care Pharmacy
  • New York, NY
  • NPI 1215551593
  NPD tax ID

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1023262136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 SURF AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242810",
            "telephone_number": "212-249-8202",
            "fax_number": "917-722-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 COLUMBUS AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100254041",
            "telephone_number": "212-222-6388",
            "fax_number": "646-386-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "909 COLUMBUS RX NY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "KRAVTSOVA",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "917-830-2522"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "038229",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02570827",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118151",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quick Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in New York, NY
• Providers in New York, 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 Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.