Organization Active NPI

Grand RX Pharmacy Inc

  • Community/Retail Pharmacy
  • Elmhurst, NY
National Provider Identifier
1194529644
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GRAND RX PHARMACY INC
Practice address
8404 Queens Blvd
Elmhurst, NY 11373-5213
Phone
(347) 395-0245
Fax
(347) 242-2148
NPI assigned
Apr 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Authorized official

Name
Moisey Rakhminov
Title
President
Phone
(347) 395-0245

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X
Mail Order Pharmacy 3336M0002X

Addresses

Primary practice location

8404 Queens Blvd
Elmhurst, NY 11373-5213

Mailing address

8404 Queens Blvd
Elmhurst, NY 11373-5213
Phone (347) 395-0245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250811001525 NY Part B Supplier - Mass Immunization (Roster Biller Only) 7012415938 Practice locations: Elmhurst, NY
O20250908000935 NY DME Supplier - Pharmacy 7012415938 Practice locations: Elmhurst, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Grand RX Pharmacy Inc8404 Queens Blvd, Elmhurst, NY 11373-5213(347) 395-0245 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Jul 1, 2025

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1194529644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8404 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735213",
            "telephone_number": "347-395-0245",
            "fax_number": "347-242-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8404 QUEENS BLVD",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735213",
            "telephone_number": "347-395-0245",
            "fax_number": "347-242-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RX PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "RAKHMINOV",
        "authorized_official_first_name": "MOISEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-395-0245"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; 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.