Organization
ISHAM BROADWAY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SATYANARAYANA NEKKANTI (PRESIDENT)
(212) 567-3137
Entity
Organization
Contact information
Practice address
4996 BROADWAY, , 212 TH STREET, NEW YORK, NY 10034
(212) 567-3137
(212) 567-3110
Mailing address
4996 BROADWAY, 212 TH STREET, NEW YORK, NY 10034
(212) 567-3137
(212) 567-3110
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01147933
—
NY
01
—
3395236
NCPDP NUMBER
NY
Enumeration date
12/14/2006
Last updated
06/06/2023
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