# 866 EAST TREMONT PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235677923
- **Authorized official:** JACOB JAMRON (CEO)
- **Authorized official phone:** (718) 971-9391

## Contact information

- **Practice address:** 864B E TREMONT AVE, BRONX, NY 10460-4201
- **Practice address phone:** (718) 991-3532
- **Practice address fax:** (718) 608-6002
- **Mailing address:** PO BOX 740054, BRONX, NY 10474-0001
- **Mailing address phone:** (718) 971-9391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2017
- **Last updated:** 04/09/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2167720 | PK | — |