Organization
BRADHURST SPECIALTY PHARMACY INC
Active
Other names
The Atrium Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES MELANCON (VICE PRESIDENT)
(917) 449-6939
Entity
Organization
Contact information
Practice address
19 BRADHURST AVE, SUITE L1, HAWTHORNE, NY 10532-2140
(914) 345-0070
(914) 345-0211
Mailing address
10050 CROSSTOWN CIR, SUITE 300, EDEN PRAIRIE, MN 55344-3348
(952) 979-3680
(952) 352-6698
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
028582
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0184781
—
NJ
05
—
02968394
—
NY
05
—
1740465814
—
CT
Enumeration date
01/08/2008
Last updated
12/03/2010
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