Organization
PROVIDENT PHARMA LLC
Active
Other names
Morris Ave Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARSH PATEL (OWNER)
(718) 292-2500
Entity
Organization
Contact information
Practice address
675 MORRIS AVE, BRONX, NY 10451-4783
(718) 292-2500
(718) 292-2600
Mailing address
675 MORRIS AVE, BRONX, NY 10451-4783
(718) 292-2500
(718) 292-2600
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
030468
NY
Other
Enumeration date
04/13/2015
Last updated
12/10/2015
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