Healthcare Provider Details

I. General information

NPI: 1649605130
Provider Name (Legal Business Name): ETMC PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2013
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 E TREMONT AVE
BRONX NY
10460-4363
US

IV. Provider business mailing address

930 E TREMONT AVE
BRONX NY
10460-4363
US

V. Phone/Fax

Practice location:
  • Phone: 718-764-1661
  • Fax: 646-224-1320
Mailing address:
  • Phone: 718-764-1661
  • Fax: 646-224-1320

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 Number031937
License Number StateNY

VIII. Authorized Official

Name: HISHAM ELZANATY
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 718-764-1661