Provider Demographics
NPI:1730973413
Name:HEALTH STATION PHARMACY CORP
Entity type:Organization
Organization Name:HEALTH STATION PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAIMOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-341-0698
Mailing Address - Street 1:755 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1030
Mailing Address - Country:US
Mailing Address - Phone:516-341-0698
Mailing Address - Fax:516-341-0699
Practice Address - Street 1:755 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1030
Practice Address - Country:US
Practice Address - Phone:516-341-0698
Practice Address - Fax:516-341-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy