Organization
PRIMARY CARE PHARMACY INC
Active
Other names
Primary Care Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDR KHAIMOV (PRESIDENT)
(917) 299-3099
Entity
Organization
Contact information
Practice address
9020 SUTPHIN BLVD, JAMAICA, NY 11435-3636
(718) 291-4747
(718) 291-4757
Mailing address
9020 SUTPHIN BLVD, JAMAICA, NY 11435-3636
(718) 291-4747
(718) 291-4757
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030742
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03339640
—
NY
01
—
5802601
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/07/2011
Last updated
12/24/2020
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