Healthcare Provider Details

I. General information

NPI: 1265461982
Provider Name (Legal Business Name): 161 ST PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 E 161ST ST
BRONX NY
10451-3504
US

IV. Provider business mailing address

275 E 161ST ST
BRONX NY
10451-3504
US

V. Phone/Fax

Practice location:
  • Phone: 718-742-3400
  • Fax: 718-742-3416
Mailing address:
  • Phone: 718-742-3400
  • Fax: 718-742-3416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number027268
License Number StateNY

VIII. Authorized Official

Name: DR. HARDY CHUNG
Title or Position: VICE PRESIDENT
Credential: RPH
Phone: 718-742-3400