Organization
GRANT PHARMA INC
Active
Other names
Grant Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRINIVASA REDDY YANNAM (PHARMACY MANAGER / PHARMACIST)
(718) 588-3304
Entity
Organization
Contact information
Practice address
1340 EDWARD L GRANT HWY, BRONX, NY 10452-3144
(718) 588-3304
(718) 588-2318
Mailing address
1340 EDWARD L GRANT HIGHWAY, BRONX, NY 10452
(718) 588-3304
(718) 588-2318
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
032731
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03885389
—
NY
01
—
2146630
PK
—
Enumeration date
03/13/2014
Last updated
10/06/2020
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