Organization
APOLLO PHARMA INC
Active
Other names
EAST BROADWAY PHARMACY, EAST BROADWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL BASTIEN (SUPERVISING PHARMACIST)
(212) 431-6688
Entity
Organization
Contact information
Practice address
98 E BROADWAY APT 1F, NEW YORK, NY 10002-7093
(212) 431-6688
(212) 431-6681
Mailing address
98 E BROADWAY APT 1F, NEW YORK, NY 10002-7093
(212) 431-6688
(212) 431-6681
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
035752
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04876775
—
NY
01
—
2172114
PK
—
Enumeration date
08/03/2017
Last updated
09/29/2022
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