Healthcare Provider Details

I. General information

NPI: 1275324717
Provider Name (Legal Business Name): AUSTIN ST CHEMISTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710A 71ST RD
FOREST HILLS NY
11375-4719
US

IV. Provider business mailing address

10710A 71ST RD
FOREST HILLS NY
11375-4719
US

V. Phone/Fax

Practice location:
  • Phone: 718-880-1514
  • Fax: 646-397-3851
Mailing address:
  • Phone: 718-880-1514
  • Fax: 646-397-3851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EMIL IBRAHIMOV
Title or Position: PRESIDENT
Credential:
Phone: 718-880-1514