Freeport RX Inc

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

FREEPORT RX INC

Practice address

132 W Sunrise Hwy
Freeport, NY 11520-3521

Phone

(646) 352-0151

Fax

(646) 352-0116

NPI assigned

Apr 17, 2025

Organization subpart

No

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

Authorized official

Name

Diana Khaimova

Title

President

Phone

(646) 352-0151

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Locations

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1730975681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 W SUNRISE HWY",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203521",
            "telephone_number": "646-352-0151",
            "fax_number": "646-352-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 W SUNRISE HWY",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115203521",
            "telephone_number": "646-352-0151",
            "fax_number": "646-352-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEPORT RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "KHAIMOVA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-352-0151"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freeport Medical Supply Inc (xtra care pharmacy)
• Freeport Pain Managment PC.
• Freeport Pride
• Freeport Pride, Inc.
• Freeport Public School
• Kaitlyn Frey
• David Friedberg, PT, DPT
• Merav Kroll Fruchter, DDS
• Christian Joy Frye, LPN
• Nicole Yvette Fuller-Richardson, LPN

• Pharmacy in Freeport, NY
• Providers in Freeport, NY by specialty
• Pharmacy in New York

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