Y S Drug Store, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

Y S DRUG STORE, INC

Practice address

13654 39TH Ave
Flushing, NY 11354-5516

Phone

(718) 461-5500

Fax

(718) 461-5501

NPI assigned

Jun 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Dae Gon Kim

Title

Owner

Phone

(347) 542-9766

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• LEWIS PHARMACY 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 3

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

• Soonbong Hwang, RPH

  • Pharmacist
  • Flushing, NY
  • NPI 1225360456
  NPD (past)
• Shin Kang

  • Pharmacist
  • Flushing, NY
  • NPI 1922330539
  NPD (past)
• Amy Wai Ki Law, RPH

  • Pharmacist
  • Flushing, NY
  • NPI 1518143718
  NPD (past)

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1215130992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13654 39TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545516",
            "telephone_number": "718-461-5500",
            "fax_number": "718-461-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13654 39TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545516",
            "telephone_number": "718-461-5500",
            "fax_number": "718-461-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "Y S DRUG STORE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DAE GON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-542-9766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00712496",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3330898",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEWIS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEWIS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kevin Xue, DMD
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• Daniel Shlomo Yaeger, DPM
• Salim Yaghi, MD
• Sabina Yagudaeva
• Ariel Yagudayev

• Community/Retail Pharmacy in Flushing, NY
• Providers in Flushing, 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 May 6, 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.