MEDICARE: BRONX DRUGS 2 INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	035404	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2169117	OTHER		PK

General Provider Information

NPI Number	:	1023558954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONX DRUGS 2 INC

Provider Business Mailing Address
First Line	:	586 E 187TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-6742
Country	:	US
Telephone Number	:	718-708-5775
Fax Number	:	718-708-5773

Provider Business Practice Location Address
First Line	:	586 E 187TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-6742
Country	:	US
Telephone Number	:	718-708-5775
Fax Number	:	718-708-5773

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TASEER J KHAN
Credential	:
Telephone Number	:	718-708-5775

Provider Enumeration Date	:	02/25/2017
Last Update Date	:	04/05/2019

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