Brand RX Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

035409 Issued in NY

Legal business name

BRAND RX PHARMACY CORP

Practice address

97-05 A 57TH Avenue
Corona, NY 11368

Phone

(718) 393-2300

Fax

(718) 393-2311

NPI assigned

May 30, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Alisho Fattahov

Title

President

Phone

(718) 393-2300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1063940443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97-05 A 57TH AVENUE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-393-2300",
            "fax_number": "718-393-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97-05 A 57TH AVENUE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "11368",
            "telephone_number": "718-393-2300",
            "fax_number": "718-393-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAND RX PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-30",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "FATTAHOV",
        "authorized_official_first_name": "ALISHO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-393-2300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Corona, NY
• Providers in Corona, 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 Jun 3, 2020; 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.