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Organization

1070 SOUTHERN DRUG LLC

Active
Other names
BOCA PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB JAMRON (CEO)
(718) 991-6700
Entity
Organization

Contact information

Practice address
1070 SOUTHERN BLVD, BRONX, NY 10459-3268
(718) 618-7878
(718) 701-0226
Mailing address
PO BOX 740054, BRONX, NY 10474-0001
(718) 618-7878
(718) 701-0226

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
033179
NY
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04105579
NY
Enumeration date
12/02/2014
Last updated
09/14/2025
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