Organization
SOUTHBRONXRXINC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AJANTHA BOMMAREDDY OWNER (PRESIDENT)
(201) 400-2286
Entity
Organization
Contact information
Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 538-3385
(718) 538-3384
Mailing address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 538-3385
(718) 538-3384
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
033226
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033226
NEW YORK STATE BOARD OF PHARMACY
NY
Enumeration date
11/18/2014
Last updated
09/20/2016
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