Active NPI
909 Columbus RX Ny LLC
- Long Term Care Pharmacy
- New York, NY
National Provider Identifier
1215551593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- 909 COLUMBUS RX NY LLC
- Practice address
- 909 Columbus Ave
New York, NY 10025-4041 - Phone
- (212) 222-6388
- Fax
- (646) 386-7656
- NPI assigned
- Jun 3, 2020
- 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
- Julia Kravtsova
- Title
- Pic
- Phone
- (917) 830-2522
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
909 Columbus Ave
New York, NY 10025-4041
Mailing address
1047 Surf Ave FL 2
Brooklyn, NY 11224-2810
Phone (917) 830-2522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210316000846 | NY | Part B Supplier - Pharmacy | 8325454515 |
1 other NPI on this enrollment Practice locations: New York, NY |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Quick Rx
- Community/Retail Pharmacy
- New York, NY
- NPI 1023262136
8325454515
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Quick Rx
- Community/Retail Pharmacy
- New York, NY
- NPI 1023262136
O20210316000846
National Provider Directory
National Provider Directory- Tax ID family
- 909 Columbus RX Corp
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
909 Columbus Ave
New York, NY 10025
Phone (212) 222-6388
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616025600000",
"number": "1215551593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1047 SURF AVE FL 2",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112242810",
"telephone_number": "917-830-2522",
"fax_number": "917-722-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 COLUMBUS AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100254041",
"telephone_number": "212-222-6388",
"fax_number": "646-386-7656"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "909 COLUMBUS RX NY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-06-03",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A",
"authorized_official_last_name": "KRAVTSOVA",
"authorized_official_first_name": "JULIA",
"authorized_official_title_or_position": "PIC",
"authorized_official_telephone_number": "917-830-2522"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.