Story Ave 24, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

STORY AVE 24, LLC

Practice address

1903 Story Ave
Bronx, NY 10473-2705

Phone

(718) 822-2923

Fax

(718) 822-2924

NPI assigned

Jul 16, 2024

Organization subpart

No

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

Authorized official

Name

Akhmed Umarov

Title

President

Phone

(718) 912-5434

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1871331769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 STORY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732705",
            "telephone_number": "718-822-2923",
            "fax_number": "718-822-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 STORY AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732705",
            "telephone_number": "718-822-2923",
            "fax_number": "718-822-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STORY AVE 24, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "UMAROV",
        "authorized_official_first_name": "AKHMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-912-5434"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Stone, LMSW
• Stop & Shop Supermarket Company, LLC
• Stop and Shop Supermarket Company, LLC
• Andrea Stopa, MSW
• Tyesha J Storey, LMSW
• Story Ave Pharmacy Inc
• McKinley Stoudermire Jr., RN
• Anna Stoupine, DPM
• Lois Stover, LMSW
• Renaldo Stover

• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, 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 Jul 16, 2024; 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.