Organization Active NPI

Green Line Pharmacy Inc

  • Long Term Care Pharmacy
  • Kew Gardens, NY
National Provider Identifier
1417716564
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GREEN LINE PHARMACY INC
Doing business as
Kew Gardens Pharmacy
Practice address
8157 Lefferts Blvd
Kew Gardens, NY 11415-1728
Phone
(718) 850-5220
Fax
(718) 850-5221
NPI assigned
Mar 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Mikhail Aminov
Title
Owner
Phone
(718) 850-5220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

8157 Lefferts Blvd
Kew Gardens, NY 11415-1728

Mailing address

8157 Lefferts Blvd
Kew Gardens, NY 11415-1728
Phone (718) 850-5220

Other names 1

  • Kew Gardens Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Green Line Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1417716564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8157 LEFFERTS BLVD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151728",
            "telephone_number": "718-850-5220",
            "fax_number": "718-850-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8157 LEFFERTS BLVD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151728",
            "telephone_number": "718-850-5220",
            "fax_number": "718-850-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LINE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "AMINOV",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-850-5220"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kew Gardens Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.