Organization
KHELLY NY II INC.
Active
Other names
EASTCHESTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BHAVNA A SHAH (PRESIDENT)
(732) 318-9628
Entity
Organization
Contact information
Practice address
2102 EASTCHESTER RD, BRONX, NY 10461-2248
(718) 684-5454
(718) 684-5456
Mailing address
2102 EASTCHESTER RD, BRONX, NY 10461-2248
(718) 684-5454
(718) 684-5456
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
031875
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031875
STATE BOARD OF PHARMACY, NEWYORK
NY
05
—
3808188
—
NY
01
—
7122950001
MEDICARE
NY
Enumeration date
04/19/2013
Last updated
12/24/2019
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