MEDICARE: SUTPHIN DRUGS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336H0001X	Home Infusion Therapy Pharmacy
2	3336C0003X	Community/Retail Pharmacy	017989	NY
3	3336S0011X	Specialty Pharmacy
4	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982766762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUTPHIN DRUGS, INC.

Provider Business Mailing Address
First Line	:	14303 HILLSIDE AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-3230
Country	:	US
Telephone Number	:	718-526-0310
Fax Number	:	718-206-2337

Provider Business Practice Location Address
First Line	:	14303 HILLSIDE AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-3230
Country	:	US
Telephone Number	:	718-526-0310
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AJAI PRAKASH
Credential	:	R.PH.
Telephone Number	:	718-526-0310

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	06/03/2026

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