Healthcare Provider Details

I. General information

NPI: 1194424994
Provider Name (Legal Business Name): BRONX HEALTH RX , INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 E 149TH ST
BRONX NY
10455-1338
US

IV. Provider business mailing address

430 E 149TH ST
BRONX NY
10455-1338
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-2820
  • Fax: 718-401-2805
Mailing address:
  • Phone: 718-401-2820
  • Fax: 718-401-2805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MAHA YVONNE MALDONADO
Title or Position: SUPERVISING PHARMACIST
Credential: RPH
Phone: 718-401-2820