MEDICARE: Q PHARMACY RX 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1992301261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	Q PHARMACY RX INC

Provider Business Mailing Address
First Line	:	8236 LEFFERTS BLVD
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2638
Country	:	US
Telephone Number	:	929-467-8013
Fax Number	:	929-467-8029

Provider Business Practice Location Address
First Line	:	8236 LEFFERTS BLVD
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2638
Country	:	US
Telephone Number	:	929-467-8013
Fax Number	:	929-467-8029

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BORISLAV YUSUPOV
Credential	:
Telephone Number	:	929-467-8013

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	12/10/2020

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