Organization Active NPI

Nyc Wholesale Inc

Doing business as moon pharmacy

  • Community/Retail Pharmacy
  • Rego Park, NY
National Provider Identifier
1376854323
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
17-030055 Issued in NY
Legal business name
NYC WHOLESALE INC
Doing business as
moon pharmacy
Practice address
63-52 Woodhaven Blvd.
Rego Park, NY 11374
Phone
(718) 739-0300
Fax
(718) 739-0301
NPI assigned
Jun 24, 2010
Organization subpart
Yes
Parent organization
NYC WHOLESALE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Authorized official

Name
George Chu
Title
Owner/President
Phone
(484) 401-2773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 17-030055 NY Primary

Addresses

Primary practice location

63-52 Woodhaven Blvd.
Rego Park, NY 11374

Mailing address

63-52 Woodhaven Blvd.
Rego Park, NY 11374
Phone (718) 739-0300

Other names 1

  • moon pharmacy Doing business as

National Provider Directory

National Provider Directory
Part of
Nyc Wholesale Inc

Locations

5702 Clarendon Rd
Brooklyn, NY 11203
Phone (347) 425-8170

15321 Hillside Ave
Jamaica, NY 11432
Phone (718) 739-0300

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1376854323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63-52 WOODHAVEN BLVD.",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-739-0300",
            "fax_number": "718-739-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63-52 WOODHAVEN BLVD.",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-739-0300",
            "fax_number": "718-739-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NYC WHOLESALE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NYC WHOLESALE INC.",
        "enumeration_date": "2010-06-24",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "484-401-2773"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "17-030055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "moon pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.