Healthcare Provider Details

I. General information

NPI: 1205078011
Provider Name (Legal Business Name): BRONX CHEMISTS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 3RD AVE
BRONX NY
10454-1117
US

IV. Provider business mailing address

2604 3RD AVE
BRONX NY
10454-1117
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-6500
  • Fax: 718-401-6502
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number029326
License Number StateNY

VIII. Authorized Official

Name: MARIO NUNES
Title or Position: OWNER
Credential:
Phone: 718-401-6500