Pharmacy 63Rd RX Corp.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PHARMACY 63RD RX CORP.

Practice address

9855 63Rd Rd
Rego Park, NY 11374-1739

Phone

(718) 897-4747

Fax

(718) 897-4748

NPI assigned

Apr 9, 2025

Organization subpart

No

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

Authorized official

Name

Stanislav Shimunov

Title

President

Phone

(718) 897-4747

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1386438604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9855 63RD RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741739",
            "telephone_number": "718-897-4747",
            "fax_number": "718-897-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9855 63RD RD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741739",
            "telephone_number": "718-897-4747",
            "fax_number": "718-897-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMACY 63RD RX CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-09",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "SHIMUNOV",
        "authorized_official_first_name": "STANISLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-897-4747"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Rego Park, NY
• Providers in Rego Park, 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 Feb 3, 2026; 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.

Verify at the official NPI Registry.