Organization
QUEENS BLVD RX CORP.
Active
Other names
PRIME MED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR SULTAN AHMADI (PHARMACIST)
(718) 872-9772
Entity
Organization
Contact information
Practice address
12084 QUEENS BLVD, KEW GARDENS, NY 11415-1204
(718) 872-9772
(646) 813-1803
Mailing address
12084 QUEENS BLVD, KEW GARDENS, NY 11415-1204
(718) 872-9772
(646) 813-1803
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05112818
—
NY
Enumeration date
01/21/2025
Last updated
09/30/2025
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