Healthcare Provider Details

I. General information

NPI: 1609712819
Provider Name (Legal Business Name): CROWN PHARMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 82ND ST
ELMHURST NY
11373-1305
US

IV. Provider business mailing address

4020 82ND ST
ELMHURST NY
11373-1305
US

V. Phone/Fax

Practice location:
  • Phone: 718-426-2525
  • Fax: 718-426-2523
Mailing address:
  • Phone: 718-426-2525
  • Fax: 718-426-2523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAVINDER RAO ANNAMANENI
Title or Position: PRESIDENT
Credential:
Phone: 347-952-4747