Organization Active NPI

Little Neck RX Corp

Doing business as Pharmaconic

  • Community/Retail Pharmacy
  • Little Neck, NY
National Provider Identifier
1841966793
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
LITTLE NECK RX CORP
Doing business as
Pharmaconic
Practice address
25437 Horace Harding Expy
Little Neck, NY 11362-1816
Phone
(718) 819-8511
Fax
(718) 819-8568
NPI assigned
Aug 20, 2021
Last updated
Sep 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Authorized official

Name
Stanislav Zavulunov, RPH
Title
President
Phone
(718) 819-8511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

25437 Horace Harding Expy
Little Neck, NY 11362-1816

Mailing address

25437 Horace Harding Expy
Little Neck, NY 11362-1816
Phone (718) 819-8511

Other names 1

  • PHARMACONIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20210928002628 NY DME Supplier - Pharmacy 6002213402 Practice locations: Little Neck, NY
O20211008001649 NY Part B Supplier - Mass Immunization (Roster Biller Only) 6002213402 Practice locations: Little Neck, NY
O20260416003498 NY Part B Supplier - Pharmacy 6002213402 Practice locations: Little Neck, NY

National Provider Directory

National Provider Directory
Tax ID family
Little Neck RX Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25437 Horace Harding Expy
Little Neck, NY 11362
Phone (718) 819-8511

Practitioners & affiliated clinicians

Practitioners 3

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": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631059200000",
    "number": "1841966793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25437 HORACE HARDING EXPY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621816",
            "telephone_number": "718-819-8511",
            "fax_number": "718-819-8568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25437 HORACE HARDING EXPY",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621816",
            "telephone_number": "718-819-8511",
            "fax_number": "718-819-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE NECK RX CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "ZAVULUNOV",
        "authorized_official_first_name": "STANISLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-819-8511",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMACONIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Little Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.