Organization
BROADWAY CARE PHARMACY LLC
Active
Other names
Broadway Care Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD MOSSAD (OWNER, AO)
(201) 437-5100
Entity
Organization
Contact information
Practice address
516 BROADWAY, BAYONNE, NJ 07002-3712
(201) 437-5100
(201) 437-6100
Mailing address
516 BROADWAY, BAYONNE, NJ 07002-3712
(201) 437-5100
(201) 437-6100
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00754300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0599174
—
NJ
01
—
2167560
PK
—
Enumeration date
01/31/2017
Last updated
07/19/2018
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