41 Avenue Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

031475 Issued in NY

Legal business name

41 AVENUE PHARMACY, LLC

Practice address

13633 37TH Ave Unit 1a
Flushing, NY 11354-4110

Phone

(718) 353-8600

NPI assigned

Sep 10, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Tristan Liu

Title

President

Phone

(646) 504-7321

Specialties & licenses 1

Addresses

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.

• Phoebe Tse, RPH

  • Pharmacist
  • New York, NY
  • NPI 1962681395
  NPD
• Mike Z Chen, PHARMD

  • Pharmacist
  • Flushing, NY
  • NPI 1013439546
  NPD (past)
• Xiaolong Li

  • Pharmacist
  • Flushing, NY
  • NPI 1699257097
  NPD (past)

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486684800000",
    "number": "1245580992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136-33 37TH AVENUE UNIT #1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545874",
            "telephone_number": "718-353-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13633 37TH AVE UNIT 1A",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544110",
            "telephone_number": "718-353-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "41 AVENUE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2017-02-10",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-504-7321",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "031475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 8282 Ambulette, Inc.
• 88 Healthy Pharmacy LLC

• All providers in Flushing, NY
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.