Organization
3340 BROADWAY PHARMACY 2 INC
Active
Other names
3340 BROADWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN PEREZ (PRESIDENT)
(212) 926-9800
Entity
Organization
Contact information
Practice address
3621 BROADWAY, NEW YORK, NY 10031-2518
(212) 926-9800
(212) 926-2228
Mailing address
3621 BROADWAY, NEW YORK, NY 10031-2518
(212) 926-9800
(212) 926-2228
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
027032
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02648108
—
NY
01
—
2063653
PK
—
Enumeration date
10/20/2006
Last updated
10/27/2014
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