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General NPI Number Information
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NPI Number | 1720168420
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Entity Type | Organization
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Legal Business Name | TOWN DRUG AT BROADWAY INC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 4764 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10034-4916
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Country | US
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Telephone | 212-304-9582
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Fax | 212-304-9713
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Provider Business Mailing Address
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Address Line | 4785 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10034
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Country | US
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Telephone | 212-304-9582
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Fax | 212-304-9713
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Authorized Official
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Title or Position | VP
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Name | SALVATORE PAGANO
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Credential | RPH
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Telephone | 212-304-9582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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