Kings Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034289 Issued in NY

Legal business name

KINGS PHARMACY INC

Doing business as

New York Ave Pharmacy

Practice address

3424 Church Ave
Brooklyn, NY 11203-2714

Phone

(718) 856-8048

Fax

(718) 469-0424

NPI assigned

Nov 24, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Jacqueline Bissah

Title

Supervising Pharmacist

Phone

(718) 856-8048

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• New York Ave 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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Western Drugs Inc

  dba Western Drugs

  • Community/Retail Pharmacy
  • Jackson Heights, NY
  • NPI 1942304902

  Member Of

  NPD member

Locations

Practitioners 2

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

• Venkata Naga Sai Jatin Gumpella, PHARM D

  • Pharmacist
  • Jamaica, NY
  • NPI 1497237531
  NPD
• Muhammad Khalique Qureshi

  • Pharmacist
  • Brooklyn, NY
  • NPI 1871774356
  NPD (past)

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1275907529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3424 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032714",
            "telephone_number": "718-856-8048",
            "fax_number": "718-469-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032714",
            "telephone_number": "718-856-8048",
            "fax_number": "718-469-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "BISSAH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "718-856-8048",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04376876",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157644",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New York Ave Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New York Ave Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kings Medical PC
• Kings Medical Services PC
• Kings Medical Services PC
• Kings Medical Suite, PC
• Kings Neurology, PC
• Kings Physician Services, PC
• Kings Physician Services, PC (Kings Emergency Physician Services)
• Kings Plaza Dental PC
• Kings Plaza Eye Care LLC (Sterling Optical)
• Kings Plaza Foot Care, PC

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, 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 Mar 3, 2023; 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.