# BROADWAY PHARMACY INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Broadway Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447703236
- **Authorized official:** MR. AVELINO JESUS AVELENDA R.PH. (OWNER/PRESIDENT/RPIC)
- **Authorized official phone:** (201) 766-9300

## Contact information

- **Practice address:** 7211 BROADWAY, NORTH BERGEN, NJ 07047-5736
- **Practice address phone:** (201) 766-9300
- **Practice address fax:** (201) 766-9298
- **Mailing address:** 7211 BROADWAY, NORTH BERGEN, NJ 07047-5736
- **Mailing address phone:** (201) 766-9300
- **Mailing address fax:** (201) 766-9298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 28RS00749800 | NJ | Yes |

## Other

- **Enumeration date:** 07/27/2016
- **Last updated:** 07/27/2016