Organization
CROTONA PHARMACY CORP
Active
Other names
Crotona Pharmacy Corp
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT FORKOSH (OFFICER)
(347) 204-5001
Entity
Organization
Contact information
Practice address
1384 BOSTON RD, BRONX, NY 10456-2541
(917) 688-1102
(917) 688-1104
Mailing address
1384 BOSTON RD, BRONX, NY 10456-2541
(917) 688-1102
(917) 688-1104
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
031218
NY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5805164
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/11/2012
Last updated
07/16/2012
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