Organization
AAAIP PHARMACY CORP
Active
Other names
AAA IP PHARMACY CORP
Organization subpart
No
Provider details
NPI number
Authorized official
PETER NIYAZOV PHARMD (PRESIDENT)
(718) 520-3460
Entity
Organization
Contact information
Practice address
12510 QUEENS BLVD, KEW GARDENS, NY 11415-1519
(718) 520-3460
(718) 520-3462
Mailing address
12510 QUEENS BLVD, KEW GARDENS, NY 11415-1519
(718) 520-3460
(718) 520-3462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
027934
NY
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2808982
—
NY
01
—
3351943
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/14/2006
Last updated
07/26/2012
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