Organization
CONCOURSE PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRASAD CHINTAMANENI (PRESIDENT)
(718) 665-0026
Entity
Organization
Contact information
Practice address
767 CONCOURSE VLG W, BRONX, NY 10451-3801
(718) 665-0026
(718) 665-6521
Mailing address
767 CONCOURSE VLG W, BRONX, NY 10451-3801
(718) 665-0026
(718) 665-6521
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
023974
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01796029
—
NY
Enumeration date
10/13/2006
Last updated
03/09/2010
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