Wall Street Super Chemists Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

029443 Issued in NY

Legal business name

WALL STREET SUPER CHEMISTS INC

Practice address

9721 57TH Ave
Corona, NY 11368-3540

Phone

(718) 699-7700

Fax

(718) 699-7222

NPI assigned

Jun 10, 2009

Organization subpart

No

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

Authorized official

Name

Usman Khan

Title

President

Phone

(718) 699-7700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• sherwood pharmacy Doing business as

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1124254677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9721 57TH AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113683540",
            "telephone_number": "718-699-7700",
            "fax_number": "718-699-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9721 57TH AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113683540",
            "telephone_number": "718-699-7700",
            "fax_number": "718-699-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALL STREET SUPER CHEMISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "USMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-699-7700"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "029443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3104652",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3362047",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sherwood pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Yue Wang

• All providers in Corona, NY
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.