Organization
PRXP OF NEW YORK LLC
Active
Other names
Broadway Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS WAKEFIELD (CORPORATE MANAGER)
(412) 477-7803
Entity
Organization
Contact information
Practice address
601 AMSTERDAM AVE, NEW YORK, NY 10024-1810
(212) 724-1950
(212) 724-1946
Mailing address
601 AMSTERDAM AVE, NEW YORK, NY 10024-1810
(212) 724-1950
(212) 724-1946
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
28RO00136100
NJ
3336C0003X
Community/Retail Pharmacy
033838
NY
3336C0003X
Community/Retail Pharmacy
PCN.0003095
CT
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04227134
—
NY
05
—
0531928
—
NJ
01
—
2153018
PK
—
Enumeration date
07/06/2015
Last updated
11/05/2024
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