Organization
SERVAID CORP
Active
Other names
1st BRONXCARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL KWAKYE (SUPERVISING PHARMACIST)
(718) 483-9891
Entity
Organization
Contact information
Practice address
438 E 149TH ST, BRONX, NY 10455-1304
(718) 843-9891
(718) 843-9893
Mailing address
438 E 149TH ST, BRONX, NY 10455-1304
(718) 843-9891
(718) 843-9893
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
032975
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168231
PK
—
Enumeration date
04/06/2017
Last updated
04/06/2017
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