Aiie Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

035838 Issued in NY

Legal business name

AIIE CORP

Doing business as

Primemed Pharmacy

Practice address

12084 Queens Blvd
Kew Gardens, NY 11415-1204

Phone

(718) 872-9772

Fax

(646) 813-1803

NPI assigned

Dec 21, 2017

Organization subpart

No

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

Authorized official

Name

Vyacheslav Fattakhov

Title

President

Phone

(718) 872-9772

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Primemed Pharmacy 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.

• Igor Fattakhov

  • Pharmacist
  • Forest Hills, NY
  • NPI 1346539145
  NPD

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1730695164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120-84 QUEENS BLVD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "11415",
            "telephone_number": "718-872-9772",
            "fax_number": "646-813-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12084 QUEENS BLVD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151204",
            "telephone_number": "718-872-9772",
            "fax_number": "646-813-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIIE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-21",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "FATTAKHOV",
        "authorized_official_first_name": "VYACHESLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-872-9772"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175280",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primemed Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Kew Gardens, NY
• Providers in Kew Gardens, 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 Oct 23, 2020; 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.