MEDICARE: ANCHOR RX PHARMACY 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033683891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHOR RX PHARMACY INC.

Provider Business Mailing Address
First Line	:	3110 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3200
Country	:	US
Telephone Number	:	516-992-8449
Fax Number	:	516-992-8451

Provider Business Practice Location Address
First Line	:	3110 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3200
Country	:	US
Telephone Number	:	516-992-8449
Fax Number	:	516-992-8451

Authorized Official
Title or Position	:	OWNER
Name	:	MAISEY KHODZHAYEV
Credential	:
Telephone Number	:	646-712-4307

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	06/10/2025

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