Organization Active NPI

Amazon Pharmacy Inc.

  • Community/Retail Pharmacy
  • Sunnyside, NY
National Provider Identifier
1851612915
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
17030141 Issued in NY
Legal business name
AMAZON PHARMACY INC.
Practice address
42-10 43Rd Ave
Sunnyside, NY 11104
Phone
(718) 768-0707
Fax
(718) 786-0709
NPI assigned
Jun 11, 2010
Last updated
Jun 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Authorized official

Name
Gigliola M DolmaianNPI 1508816646
Title
President
Phone
(718) 986-3433

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 17030141 NY Primary

Addresses

Primary practice location

42-10 43Rd Ave
Sunnyside, NY 11104

Mailing address

42-10 43Rd Ave
Sunnyside, NY 11104
Phone (718) 768-0707

Other identifiers 1

IdentifierTypeStateIssuer
03261007MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101104001687 NY DME Supplier - Pharmacy 9931393774 Practice locations: Sunnyside, NY

National Provider Directory

National Provider Directory

Locations

4210 43rd Ave
Sunnyside, NY 11104
Phone (718) 768-0707

4310 Queens Blvd
Sunnyside, NY 11104
Phone (718) 786-0707

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": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1851612915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42-10 43RD AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "11104",
            "telephone_number": "718-768-0707",
            "fax_number": "718-786-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42-10 43RD AVE",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "11104",
            "telephone_number": "718-768-0707",
            "fax_number": "718-786-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZON PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "DOLMAIAN",
        "authorized_official_first_name": "GIGLIOLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-986-3433"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "17030141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03261007",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.