Organization
514 WILLIS AVE PHARMACY CORP
Active
Other names
Boca Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB JAMRON (CEO)
(718) 991-3519
Entity
Organization
Contact information
Practice address
514 WILLIS AVE, BRONX, NY 10455-4028
(718) 292-7979
(718) 701-0974
Mailing address
514 WILLIS AVE, BRONX, NY 10455-4028
(718) 292-7979
(718) 701-0974
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
032158
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142577
PK
—
Enumeration date
07/01/2013
Last updated
07/19/2018
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