Organization
866 EAST TREMONT PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB JAMRON (CEO)
(718) 971-9391
Entity
Organization
Contact information
Practice address
864B E TREMONT AVE, BRONX, NY 10460-4201
(718) 991-3532
(718) 608-6002
Mailing address
PO BOX 740054, BRONX, NY 10474-0001
(718) 971-9391
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167720
PK
—
Enumeration date
02/02/2017
Last updated
04/09/2020
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