Organization
BROADWAY FAMILY PHARMACY PLLC
Active
Other names
Broadway Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
OBINNA AKUBUKWE PHARM D (PHARMACIST IN CHARGE, OWNER)
(602) 384-0301
Entity
Organization
Contact information
Practice address
6006 S CENTRAL AVE, PHOENIX, AZ 85042-4235
(602) 276-5485
(602) 276-0485
Mailing address
16538 W CENTRAL ST, SURPRISE, AZ 85388-1183
(602) 384-0301
(602) 276-0485
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005639
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140402
PK
—
05
—
818252
—
AZ
Enumeration date
05/20/2013
Last updated
05/09/2016
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