Organization Active NPI

Super RX Pharmacy Inc

  • Community/Retail Pharmacy
  • Richmond Hill, NY
National Provider Identifier
1568403467
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
027533 Issued in NY
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

Updated by the provider on Mar 9, 2015

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

Authorized official

Name
Joseph SwamiNPI 1578715090
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2721126MedicaidNY
2067344OtherPK

Other names 1

  • RICHMOND RX CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

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.

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.

Verify at the official NPI Registry.