Organization Active NPI

Queens Central Pharmacy Inc

  • Community/Retail Pharmacy
  • Forest Hills, NY
National Provider Identifier
1053624536
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
030171 Issued in NY
Legal business name
QUEENS CENTRAL PHARMACY INC
Doing business as
Queens Central Pharmacy, Inc
Practice address
11608 Queens Blvd
Forest Hills, NY 11375-7055
Phone
(718) 268-8060
Fax
(718) 268-8070
NPI assigned
Jul 26, 2010
Last updated
Mar 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Authorized official

Name
Igor AronovNPI 1609043215
Title
Owner/Pharmacist
Phone
(718) 268-8060

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 030171 NY Primary

Addresses

Primary practice location

11608 Queens Blvd
Forest Hills, NY 11375-7055

Mailing address

11608 Queens Blvd
Forest Hills, NY 11375-7055
Phone (718) 268-8060

Other identifiers 2

IdentifierTypeStateIssuer
2126121OtherPK
3268742MedicaidNY

Other names 1

  • Queens Central 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
O20101108000461 NY DME Supplier - Pharmacy 3274728050 Practice locations: Forest Hills, NY
O20171011000001 NY Part B Supplier - Mass Immunization (Roster Biller Only) 3274728050 Practice locations: Forest Hills, NY

National Provider Directory

National Provider Directory

Locations

11608 Queens Blvd
Forest Hills, NY 11375
Phone (347) 204-1199

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489104000000",
    "number": "1053624536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11608 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757055",
            "telephone_number": "718-268-8060",
            "fax_number": "718-268-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11608 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757055",
            "telephone_number": "718-268-8060",
            "fax_number": "718-268-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS CENTRAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-26",
        "last_updated": "2017-03-10",
        "status": "A",
        "authorized_official_last_name": "ARONOV",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "718-268-8060"
    },
    "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": "030171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2126121",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3268742",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queens Central Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; 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.