Super Pharmacy RX Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SUPER PHARMACY RX INC

Practice address

20520 Jamaica Ave
Hollis, NY 11423-3021

Phone

(718) 465-5200

Fax

(718) 465-5300

NPI assigned

Apr 26, 2017

Organization subpart

No

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

Authorized official

Name

Wendy Pafos

Title

Manager

Phone

(718) 465-5200

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1952836009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20520 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114233021",
            "telephone_number": "718-465-5200",
            "fax_number": "718-465-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20520 JAMAICA AVE",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114233021",
            "telephone_number": "718-465-5200",
            "fax_number": "718-465-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER PHARMACY RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "PAFOS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-465-5200"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2169128",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• State of New York Comptrollers Office
• Stephanie Fuller NP in Family Health PC
• Donald Stephen
• Eileen Sterling
• Stephanie Suleymanov
• Superior Physical Therapy, P.C.
• Supreme Medical Care, PLLC.
• Lauren Irene Sutherland, LPN
• Usha Tandon, MD
• Stacy Taubenfeld, LMSW

• Community/Retail Pharmacy in Hollis, NY
• Providers in Hollis, 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 May 1, 2017; 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.