MEDICARE: SUPER PHARMACY RX 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2169128	OTHER		PK

General Provider Information

NPI Number	:	1952836009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPER PHARMACY RX INC

Provider Business Mailing Address
First Line	:	20520 JAMAICA AVE
Second Line	:
City	:	HOLLIS
State	:	NY
Zip	:	11423-3021
Country	:	US
Telephone Number	:	718-465-5200
Fax Number	:	718-465-5300

Provider Business Practice Location Address
First Line	:	20520 JAMAICA AVE
Second Line	:
City	:	HOLLIS
State	:	NY
Zip	:	11423-3021
Country	:	US
Telephone Number	:	718-465-5200
Fax Number	:	718-465-5300

Authorized Official
Title or Position	:	MANAGER
Name	:	WENDY PAFOS
Credential	:
Telephone Number	:	718-465-5200

Provider Enumeration Date	:	04/26/2017
Last Update Date	:	05/01/2017

Similar Medicare Providers

1972112993 — BISOMA PHARMACY INC
Practice Location Address:

20520 JAMAICA AVE
HOLLIS, NY
11423-3021

Practice Phone: 718-217-2091
Practice Fax: 718-217-2138

1205155090 — GLADYS OZOUDE R.N.
Practice Location Address:

19550 JAMAICA AVE STE B
HOLLIS, NY
11423-2664

Practice Phone: 347-545-2806
Practice Fax: 718-776-5005

1902769623 — MR. ANGELO PUNO SAMANO
Practice Location Address:

198-12 HILLSIDE AVENUE , APT 2R
HOLLIS, NY
11423

Practice Phone: 914-473-0463
Practice Fax:

1336002062 — PATRICK FARRELL
Practice Location Address:

20417 HILLSIDE AVE STE 125
HOLLIS, NY
11423-2213

Practice Phone: 917-352-3995
Practice Fax:

1265113344 — ALL MED RX INC
Practice Location Address:

19619 JAMAICA AVE
HOLLIS, NY
11423-2641

Practice Phone: 929-499-3013
Practice Fax: 929-499-3014

1457213936 — CLEVER MEDS RX INC
Practice Location Address:

20503 JAMAICA AVE
HOLLIS, NY
11423-3039

Practice Phone: 718-470-2555
Practice Fax: 718-470-2031

Directions to “SUPER PHARMACY RX INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.