Organization
LA HISPANA ON BROADWAY PHARMACY LLC
Active
Other names
La Hispana on Broadway Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES SEIDE (PARTNER)
(516) 375-4464
Entity
Organization
Contact information
Practice address
3890 BROADWAY, NEW YORK, NY 10032-1509
(212) 568-6878
(212) 568-6877
Mailing address
3890 BROADWAY, NEW YORK, NY 10032-1509
(212) 568-6878
(212) 568-6877
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
029488
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3361932
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/27/2009
Last updated
08/18/2009
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