Organization
MONTEFIORE MEDICAL CENTER
Active
Other names
Montefiore Community Pharmacy @ CHAM
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN TUCKMAN (MANAGER)
(718) 920-5194
Entity
Organization
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 484-5160
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 484-5160
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034452
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162482
PK
—
Enumeration date
02/10/2016
Last updated
09/21/2016
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