Organization
5247 BROADWAY DRUGS INC
Active
Other names
DRUG MART
Organization subpart
No
Provider details
NPI number
Authorized official
ASHOK BARVALIA (PRESIDENT,AO)
(718) 562-6637
Entity
Organization
Contact information
Practice address
5203A BROADWAY, BRONX, NY 10463-7636
(718) 562-6637
(718) 562-5031
Mailing address
5203A BROADWAY, BRONX, NY 10463-7636
(718) 562-6637
(718) 562-5031
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
022921
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01639367
—
NY
01
—
2060694
PK
—
Enumeration date
07/22/2006
Last updated
05/14/2015
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