MEDICARE: BRONX PRESCRIPTION CENTER SOUTH 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	3336C0003X	Community/Retail Pharmacy	011440	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1669469698	OTHER		NPI

General Provider Information

NPI Number	:	1669469698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONX PRESCRIPTION CENTER SOUTH INC

Provider Business Mailing Address
First Line	:	70 E 161ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-2207
Country	:	US
Telephone Number	:	718-665-1163
Fax Number	:	718-665-8356

Provider Business Practice Location Address
First Line	:	70 E 161ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-2207
Country	:	US
Telephone Number	:	718-665-1163
Fax Number	:	718-665-8356

Authorized Official
Title or Position	:	SUPERVISING PHARMACIST
Name	:	MR. ABHIRAMA PHILKHANA
Credential	:
Telephone Number	:	718-665-1163

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	05/02/2025

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