FRESH RX LLC (NPI# 1902414048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902414048 |
| Entity Type | Organization |
| Organization Name | FRESH RX LLC |
| Other Organization Name | NEW GRACE PHARMACY |
| Practice Address |
436 Nome Ave Staten Island NY 10314-6039 |
| Practice Telephone | 7184943758 |
| Practice Fax Number | 7184943600 |
| Mailing Telephone | 7184943758 |
| Mailing Fax Number | 7184943600 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-09-26 |
| Authorized Official Name | EDUARD YAKUBOV (OWNER) |
| Authorized Official Telephone | 3472516191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| New Grace Pharmacy | Doing Business As Name - Organization |
| New Grace Pharmacy LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194369777 | Fresh Rx LLC | Pharmacy | 18417 Colima Rd, Rowland Heights, CA 91748-2898 | 2019-11-06 |
| 1942684329 | Fresh Rx LLC | Pharmacy | 565 Goddard Ave, Ignacio, CO 81137-0347 | 2015-07-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Fresh Rx LLC | 565 Goddard Ave, Ignacio, CO 81137 |
| Street Address |
436 NOME AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-6039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558910711 | Nome Pharmacy Inc | Pharmacy | 436 Nome Ave, Staten Island, NY 10314-6039 | 2019-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111951 | Pharmacy On Bay Street Inc. | Pharmacy | 1209 Bay St, Staten Island, NY 10305-3121 | 2020-10-13 |
| 1013547629 | Sunning Pharmacy Inc. | Pharmacy | 1836 Hylan Blvd Ste B, Staten Island, NY 10305-1935 | 2020-01-22 |
| 1780221879 | Nile Care Pharma Corp. | Pharmacy | 1509 Hylan Blvd, Staten Island, NY 10305-1907 | 2019-12-08 |
| 1295377760 | Rx Box Pharmacy Corp. | Pharmacy | 3265 Richmond Ave, Staten Island, NY 10312-2123 | 2019-10-16 |
| 1174088348 | H&r Nyc Pharmaceutical LLC | Pharmacy | 1265 Clove Rd # Storee, Staten Island, NY 10301-4339 | 2019-02-01 |
| 1013488121 | Michael Michail | Pharmacy | 36 Prices Ln, Staten Island, NY 10314-4618 | 2018-12-16 |
| 1841616208 | Ibram Pharmacy Inc | Pharmacy | 1756 Hylan Blvd, Staten Island, NY 10305-1932 | 2014-03-10 |
| 1912258807 | Victory Family Pharmacy, LLC | Pharmacy | 1975 Victory Blvd Ste A, Staten Island, NY 10314-3536 | 2012-10-02 |
| 1356609143 | New Dorp Pharmacy Corp | Pharmacy | 62 New Dorp Plz, Staten Island, NY 10306-2920 | 2012-04-30 |
| 1093985079 | Walgreen Co | Pharmacy | 1759 Hylan Blvd, Staten Island, NY 10305-1916 | 2008-03-06 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
Please comment or provide details below to improve the information on FRESH RX LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.