Organization
MALCOLM PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLIKARJUNA REDDY BOMMAREDDY (PRESIDENT)
(212) 722-1550
Entity
Organization
Contact information
Practice address
160 LENOX AVE, NEW YORK, NY 10026-1319
(212) 722-1550
(212) 722-4461
Mailing address
160 LENOX AVE, NEW YORK, NY 10026-1319
(212) 722-1550
(212) 722-4461
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
025096
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02188856
—
NY
Enumeration date
09/27/2006
Last updated
06/28/2023
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