Healthcare Provider Details

I. General information

NPI: 1669469698
Provider Name (Legal Business Name): BRONX PRESCRIPTION CENTER SOUTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E 161ST ST
BRONX NY
10451-2207
US

IV. Provider business mailing address

70 E 161ST ST
BRONX NY
10451-2207
US

V. Phone/Fax

Practice location:
  • Phone: 718-665-1163
  • Fax: 718-665-8356
Mailing address:
  • Phone: 718-665-1163
  • Fax: 718-665-8356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number011440
License Number StateNY

VIII. Authorized Official

Name: MR. ABHIRAMA PHILKHANA
Title or Position: SUPERVISING PHARMACIST
Credential:
Phone: 718-665-1163