Provider Demographics
NPI:1144235763
Name:COMPREHENSIVE PHARMACY
Entity Type:Organization
Organization Name:COMPREHENSIVE PHARMACY
Other - Org Name:ALCHEMY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-896-1200
Mailing Address - Street 1:9718 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9718 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3245
Practice Address - Country:US
Practice Address - Phone:718-896-1200
Practice Address - Fax:718-896-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027012333600000X
3336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3341396OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NY02620331Medicaid
3341396OtherOTHER ID NUMBER-COMMERCIAL NUMBER