Healthcare Provider Details

I. General information

NPI: 1619802345
Provider Name (Legal Business Name): BROOK SPECIALTY PHARMACY RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 BROOK AVE
BRONX NY
10455-1357
US

IV. Provider business mailing address

700 BROOK AVE
BRONX NY
10455-1357
US

V. Phone/Fax

Practice location:
  • Phone: 718-292-1310
  • Fax:
Mailing address:
  • Phone: 718-292-1310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KIZZIE L JONES
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 718-292-1310