Healthcare Provider Details

I. General information

NPI: 1255802153
Provider Name (Legal Business Name): REALVALUE PATIENTS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 37TH AVE UNIT 7
JACKSON HEIGHTS NY
11372-7917
US

IV. Provider business mailing address

9401 37TH AVE # 7
JACKSON HEIGHTS NY
11372-7917
US

V. Phone/Fax

Practice location:
  • Phone: 347-699-1237
  • Fax: 347-699-1237
Mailing address:
  • Phone: 347-699-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. ASHOKA BENEDICT GOMES
Title or Position: CEO/ DOCTOR OF PHARMACY
Credential: BS, MS, PHARMD
Phone: 347-699-1237