MEDICARE: SHALOMS 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336S0011X	Specialty Pharmacy
5	3336C0003X	Community/Retail Pharmacy	030383	NY

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
2	2127819	OTHER		PK

General Provider Information

NPI Number	:	1841509296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHALOMS PHARMACY INC

Provider Business Mailing Address
First Line	:	1490 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4714
Country	:	US
Telephone Number	:	718-253-4900
Fax Number	:	718-253-4905

Provider Business Practice Location Address
First Line	:	1490 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4714
Country	:	US
Telephone Number	:	718-253-4900
Fax Number	:	718-253-4905

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	SHALOM RAKHMINOV
Credential	:	PHARM D.
Telephone Number	:	917-650-4009

Provider Enumeration Date	:	10/04/2010
Last Update Date	:	09/19/2025

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Directions to “SHALOMS PHARMACY INC ” Practice Location

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