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General NPI Number Information
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NPI Number | 1376796078
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Entity Type | Organization
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Legal Business Name | BBRX3LLC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 189 7TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11215-3013
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Country | US
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Telephone | 718-369-6100
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Fax | 718-369-6101
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Provider Business Mailing Address
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Address Line | 189 7TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11215-3013
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Country | US
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Telephone | 718-369-6100
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Fax | 718-369-6101
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Authorized Official
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Title or Position | OWNER/SUPERVISING PHARMACIST
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Name | MR. WILLIAM J BROWNSTEIN
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Credential | R PH
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Telephone | 718-369-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 029125
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License Number State | NY
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