Organization Active NPI

Friends Pharmacy Inc

  • Pharmacy
  • Brooklyn, NY
National Provider Identifier
1053601831
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
030710 Issued in NY
Legal business name
FRIENDS PHARMACY INC
Doing business as
Friends Pharmacy Inc
Practice address
342 Kings Hwy
Brooklyn, NY 11223-1478
Phone
(718) 753-4900
Fax
(718) 753-4939
NPI assigned
Apr 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Dmitry RaytburgNPI 1891943874
Title
Supervising Pharmacist
Phone
(718) 753-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 030710 NY Primary

Addresses

Primary practice location

342 Kings Hwy
Brooklyn, NY 11223-1478

Mailing address

342 Kings Hwy
Brooklyn, NY 11223-1478
Phone (718) 753-4900

Other identifiers 2

IdentifierTypeStateIssuer
5802625OtherNCPDP PROVIDER IDENTIFICATION NUMBER
03341031MedicaidNY

Other names 1

  • Friends Pharmacy Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110801000742 NY DME Supplier - Pharmacy 6204005622 Practice locations: Brooklyn, NY
O20210611002067 NY Part B Supplier - Mass Immunization (Roster Biller Only) 6204005622 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Tax ID family
Friends Pharmacy Inc2 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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1053601831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231478",
            "telephone_number": "718-753-4900",
            "fax_number": "718-753-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112231478",
            "telephone_number": "718-753-4900",
            "fax_number": "718-753-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-13",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "RAYTBURG",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-753-4900"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "030710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5802625",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03341031",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friends Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.