Organization Active NPI

Enexia Pharmacy LLC

  • Long Term Care Pharmacy
  • Canton, OH
National Provider Identifier
1689562217
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
ENEXIA PHARMACY LLC
Practice address
114 12TH St NE
Canton, OH 44704-1024
Phone
(330) 304-3311
NPI assigned
Jun 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Mr. Boris Natenzon, RPH
Title
President
Phone
(917) 734-4662

Specialties & licenses 1

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

Addresses

Primary practice location

114 12TH St NE
Canton, OH 44704-1024

Mailing address

826 Forest Ave
Staten Island, NY 10310-2446
Phone (917) 734-4662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260212000452 OH DME Supplier - Pharmacy 7719471333 Practice locations: Canton, OH
O20260225000321 OH Part B Supplier - Pharmacy 7719471333 Practice locations: Canton, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Enexia Pharmacy LLC114 12TH St NE, Canton, OH 44704-1024(330) 304-3311 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Feb 17, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1750723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1689562217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102446",
            "telephone_number": "917-734-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 12TH ST NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447041024",
            "telephone_number": "330-304-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENEXIA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "NATENZON",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-734-4662",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.