Great Neck RX Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

GREAT NECK RX INC.

Doing business as

Pillsource Pharmacy Inc.

Practice address

140A Middle Neck Rd
Great Neck, NY 11021-1232

Phone

(516) 304-5648

NPI assigned

Sep 7, 2023

Last updated

May 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Boris Maksumov

Title

Owner

Phone

(954) 736-6957

Specialties & licenses 1

Addresses

Other names 1

• Pillsource Pharmacy Inc. Doing business as

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

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.

• Ilya Nektalov

  • Pharmacist
  • Rego Park, NY
  • NPI 1316435290
  NPD

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1174309850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140A MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140A MIDDLE NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110211232",
            "telephone_number": "516-304-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT NECK RX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "MAKSUMOV",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-736-6957",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pillsource Pharmacy Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Great Neck Podiatry Associates
• Great Neck Podiatry Associates
• Great Neck Public Schools
• Great Neck Radiologists, PC
• Great Neck Rheumatology PLLC
• Great Neck Vascular Surgery PC
• Shari B Green, M.D.
• Michael Lance Greenbaum, DDS
• Andrew Scott Greenberg, M.D.
• Burt M Greenberg, MD

• Pharmacy in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.