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Organization
PK PHARMACY.INC
Active
Organization
PK PHARMACY.INC
Active
Other names
PK PHARMACY.INC
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM NORONHA (PRESIDENT)
(516) 426-6839
Entity
Organization
Contact information
Practice address
811 SOUTHERN BLVD, BRONX, NY 10459-5202
(718) 343-3860
Mailing address
811 SOUTHERN BLVD, BRONX, NY 10459-5202
(718) 343-3860
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
Primary
033914
NY
3336C0003X
Community/Retail Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153014
PK
—
Enumeration date
10/12/2015
Last updated
10/12/2015
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