Active NPI
Super RX Pharmacy Inc
- Community/Retail Pharmacy
- Richmond Hill, NY
National Provider Identifier
1568403467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 027533
- Legal business name
- SUPER RX PHARMACY INC
- Doing business as
- RICHMOND RX CENTER
- Practice address
- 112 12 Liberty Ave
Richmond Hill, NY 11419 - Phone
- (718) 845-3540
- Fax
- (718) 845-3625
- NPI assigned
- Jun 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph Swami
- Title
- Owner/Secretary
- Phone
- (718) 845-3540
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 027533 | NY | Primary |
Addresses
Primary practice location
112 12 Liberty Ave
Richmond Hill, NY 11419
Mailing address
112 12 Liberty Ave
Richmond Hill, NY 11419
Phone (718) 845-3540
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2721126 | Medicaid | NY | |
| 2067344 | Other | PK |
Other names 1
- RICHMOND RX CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190219001627 | NY | DME Supplier - Pharmacy | 4587902440 | Practice locations: Richmond Hill Queens, NY |
| O20220902001794 | NY | Part B Supplier - Pharmacy | 4587902440 | Practice locations: South Richmond Hill, NY |
National Provider Directory
National Provider DirectoryLocations
11212 Liberty Ave
South Richmond Hill, NY 11419
Phone (718) 845-3540
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- South Richmond Hill, NY
- NPI 1578715090
-
- Pharmacist
- South Richmond Hill, NY
- NPI 1245482777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1425859200000",
"number": "1568403467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 12 LIBERTY AVE",
"city": "RICHMOND HILL",
"state": "NY",
"postal_code": "11419",
"telephone_number": "718-845-3540",
"fax_number": "718-845-3625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 12 LIBERTY AVE",
"city": "RICHMOND HILL",
"state": "NY",
"postal_code": "11419",
"telephone_number": "718-845-3540",
"fax_number": "718-845-3625"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPER RX PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-10",
"last_updated": "2015-03-09",
"status": "A",
"authorized_official_last_name": "SWAMI",
"authorized_official_first_name": "JOSEPH",
"authorized_official_title_or_position": "OWNER/SECRETARY",
"authorized_official_telephone_number": "718-845-3540"
},
"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": "027533",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2721126",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2067344",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "RICHMOND RX CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Richmond Hill, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.