Healthcare Provider Details

I. General information

NPI: 1881530335
Provider Name (Legal Business Name): ELIXIR PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162-20 UNION TURNPIKE STORE 102
FRESH MEADOWS NY
11366
US

IV. Provider business mailing address

162-20 UNION TURNPIKE STORE 102
FRESH MEADOWS NY
11366
US

V. Phone/Fax

Practice location:
  • Phone: 718-487-3015
  • Fax: 718-487-3017
Mailing address:
  • Phone: 718-487-3015
  • Fax: 718-487-3017

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: ELIZABETH BOBOYEV
Title or Position: PRESIDENT/SUPERVISING PHARMACIST
Credential:
Phone: 718-487-3015