Healthcare Provider Details

I. General information

NPI: 1770339921
Provider Name (Legal Business Name): UNION COMMUNITY HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 188TH ST STE 100
BRONX NY
10458-5302
US

IV. Provider business mailing address

260 E 188TH ST
BRONX NY
10458-5302
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-2020
  • Fax:
Mailing address:
  • Phone: 718-220-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SONIA KAPUR
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 718-618-8854