Provider Demographics
NPI:1659654630
Name:ARX ACCURATE RX SPECIALTY PHARMACY CORP
Entity Type:Organization
Organization Name:ARX ACCURATE RX SPECIALTY PHARMACY CORP
Other - Org Name:APOTHETECH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:YAKOV
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDURAKHMANOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:718-441-5474
Mailing Address - Street 1:85-48 118TH ST
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2908
Mailing Address - Country:US
Mailing Address - Phone:718-441-5474
Mailing Address - Fax:718-441-5469
Practice Address - Street 1:8548 118TH ST
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2908
Practice Address - Country:US
Practice Address - Phone:718-441-5474
Practice Address - Fax:718-441-5469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336S0011X
NY0328223336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04664013Medicaid
NY3448322Medicaid
2147400OtherPK