Organization
BROADWAY DISCOUNT PHARMACY LLC
Active
Other names
Broadway Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR DHADUK (OWNER)
(201) 916-7123
Entity
Organization
Contact information
Practice address
1765 N BROADWAY AVE, BARTOW, FL 33830-3104
(863) 537-7656
(863) 537-7927
Mailing address
4040 SUNSET LAKE DR, LAKELAND, FL 33810-2841
(201) 916-7123
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH31216
FL
Other
Enumeration date
03/01/2018
Last updated
06/25/2019
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