Provider Demographics
NPI:1033654017
Name:QUEENS PHARMACY CENTER INC.
Entity Type:Organization
Organization Name:QUEENS PHARMACY CENTER INC.
Other - Org Name:QUEENS PHARMACY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-380-1261
Mailing Address - Street 1:8235 164TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1120
Mailing Address - Country:US
Mailing Address - Phone:718-380-1261
Mailing Address - Fax:718-380-0042
Practice Address - Street 1:8235 164TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1120
Practice Address - Country:US
Practice Address - Phone:718-380-1261
Practice Address - Fax:718-380-0042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy