OrganizationActive
63rd Drive Rx, Inc.
NPI 1285451161 · Long Term Care Pharmacy · Jackson Heights, NY
Provider details
- NPI number
- 1285451161
- Entity type
- Organization
- Primary specialty
- Long Term Care PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Dmitriy Evtyushkin, Owner(915) 213-8519
Specialties & taxonomies
Suppliers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9418 Roosevelt Ave # 11c11d
Jackson Heights, NY 11372-7916
Phone: (718) 440-4917
Fax: (888) 654-4334
Street-level locationGet directions
Mailing address
9418 Roosevelt Ave # 11c11d
Jackson Heights, NY 11372-7916
Other names (DBA / former)
- Doing business as
- Interpharm Rx
Registry dates
- Enumerated
- 2024-09-23
- Last updated
- 2024-09-23
- Certified
- 2024-09-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.