18TH Ave Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

025629 Issued in NY

Legal business name

18TH AVE PHARMACY CORP

Practice address

5411 18TH Ave
Brooklyn, NY 11204-1928

Phone

(718) 331-3600

Fax

(718) 331-3099

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Grigory Beylik

Title

President

Phone

(718) 331-3600

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• 18TH AVE PHARMACY CORP Doing business as

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1285748251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041928",
            "telephone_number": "718-331-3600",
            "fax_number": "718-331-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 18TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112041928",
            "telephone_number": "718-331-3600",
            "fax_number": "718-331-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "18TH AVE PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "BEYLIK",
        "authorized_official_first_name": "GRIGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-331-3600"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "025629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02376772",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2058804",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "18TH AVE PHARMACY CORP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.