Provider Demographics
NPI:1265821086
Name:AVONORA INC
Entity Type:Organization
Organization Name:AVONORA INC
Other - Org Name:AVONORA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-969-3300
Mailing Address - Street 1:14901 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3849
Mailing Address - Country:US
Mailing Address - Phone:718-969-3300
Mailing Address - Fax:718-969-0200
Practice Address - Street 1:14901 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3849
Practice Address - Country:US
Practice Address - Phone:718-969-3300
Practice Address - Fax:718-969-0200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-16
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04348514Medicaid
NY7488310001Medicare NSC