Active NPI
Roosevelt Aid Pharmacy Inc
- Community/Retail Pharmacy
- Woodside, NY
National Provider Identifier
1154861458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- ROOSEVELT AID PHARMACY INC
- Practice address
- 6508 Roosevelt Ave
Woodside, NY 11377-2928 - Phone
- (347) 448-6965
- Fax
- (347) 448-6826
- NPI assigned
- Mar 6, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eduard Katanov
- Title
- President
- Phone
- (347) 448-6965
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 033425 | NY | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
6508 Roosevelt Ave
Woodside, NY 11377-2928
Mailing address
6508 Roosevelt Ave
Woodside, NY 11377-2928
Phone (347) 448-6965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2167798 | Other | PK |
Other names 1
- HUDSON PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171031001067 | NY | DME Supplier - Pharmacy | 3274809660 | Practice locations: Woodside, NY |
| O20220623002938 | NY | Part B Supplier - Mass Immunization (Roster Biller Only) | 3274809660 | Practice locations: Woodside, NY |
Laboratory certificates & supplier records
Derived by NPIMapThese 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
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Roosevelt Aid Pharmacy Inc | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Walkers|Wheelchairs (Standard Manual)|Nebulizer Equipment and/or Supplies | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
6508 Roosevelt Ave
Woodside, NY 11377
Phone (347) 448-6965
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776297600000",
"number": "1154861458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6508 ROOSEVELT AVE",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113772928",
"telephone_number": "347-448-6965",
"fax_number": "347-448-6826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6508 ROOSEVELT AVE",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113772928",
"telephone_number": "347-448-6965",
"fax_number": "347-448-6826"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROOSEVELT AID PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-06",
"last_updated": "2026-04-16",
"certification_date": "2026-04-16",
"status": "A",
"authorized_official_last_name": "KATANOV",
"authorized_official_first_name": "EDUARD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "347-448-6965"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NY",
"license": "033425",
"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": "PK",
"identifier": "2167798",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HUDSON PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Woodside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.