Organization Active NPI

Queens Park Rd LLC

Doing business as Queens Specialty Pharmacy

  • Community/Retail Pharmacy
  • Charlotte, NC
National Provider Identifier
1699516575
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
QUEENS PARK RD LLC
Doing business as
Queens Specialty Pharmacy
Practice address
10635 Park Rd Unit C
Charlotte, NC 28210-8408
Phone
(980) 880-6400
NPI assigned
Jun 4, 2024
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Rutvij Parikh, PHARMDNPI 1831632207
Title
Owner
Phone
(980) 880-6400

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary
Compounding Pharmacy 3336C0004X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

10635 Park Rd Unit C
Charlotte, NC 28210-8408

Mailing address

10635 Park Rd Unit C
Charlotte, NC 28210-8408

Other names 1

  • Queens Specialty Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250305000396 NC Part B Supplier - Pharmacy 6800317041 Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

10635 Park Rd
Ste C
Charlotte, NC 28210
Phone (980) 880-6800

10635 Park Rd
Unit C
Charlotte, NC 28210
Phone (980) 880-6400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1699516575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10635 PARK RD UNIT C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10635 PARK RD UNIT C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108408",
            "telephone_number": "980-880-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENS PARK RD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "PARIKH",
        "authorized_official_first_name": "RUTVIJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-880-6400",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queens Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Queens Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.