Organization
ETBA PHARMACY INC.
Active
Other names
Brook Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAMALA IYER PHARMACIST (PHARMACIST/MANAGER)
(718) 665-2018
Entity
Organization
Contact information
Practice address
530 E 138TH ST, BRONX, NY 10454-4906
(718) 665-2018
(718) 665-3575
Mailing address
530 E 138TH ST, BRONX, NY 10454-4906
(718) 665-2018
(718) 665-3575
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
027244
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02646808
—
NY
01
—
027244
BOARD OF PHARMACY
NY
Enumeration date
10/18/2005
Last updated
03/07/2023
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