Ebi Pharmacy & Supermarket Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

030373 Issued in NY

Legal business name

EBI PHARMACY & SUPERMARKET INC

Doing business as

EBI PHARMACY & SUPERMARKET INC.

Practice address

21620 Hillside Ave
Queens Village, NY 11427-1947

Phone

(718) 217-7700

Fax

(718) 217-6861

NPI assigned

Nov 22, 2010

Organization subpart

No

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

Authorized official

Name

Charles Igbodo

Title

President

Phone

(718) 217-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• EBI PHARMACY & SUPERMARKET INC. Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yibo Sun, PHARM D

  • Pharmacist
  • Queens Village, NY
  • NPI 1891095907
  NPD (past)

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1730481847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21620 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271947",
            "telephone_number": "718-217-7700",
            "fax_number": "718-217-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21620 HILLSIDE AVE",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271947",
            "telephone_number": "718-217-7700",
            "fax_number": "718-217-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBI PHARMACY & SUPERMARKET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "IGBODO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-217-7700"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5801370",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EBI PHARMACY & SUPERMARKET INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.