Broad and Grange Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481783 Issued in PA

Legal business name

BROAD AND GRANGE PHARMACY

Doing business as

Broad and Grange Pharmacy

Practice address

5751 N Broad St
Philadelphia, PA 19141-2300

Phone

(215) 424-2611

Fax

(215) 424-6927

NPI assigned

Feb 8, 2008

Last updated

Jun 13, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brian Snyder

Title

President

Phone

(215) 228-9007

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BROAD AND GRANGE PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1093993388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412300",
            "telephone_number": "215-424-2611",
            "fax_number": "215-424-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5751 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191412300",
            "telephone_number": "215-424-2611",
            "fax_number": "215-424-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD AND GRANGE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-228-9007"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2082477",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROAD AND GRANGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy Lynn Brix, NP
• Hernan R Brizuela, M.D.
• Jenna Lohre Brkich, DPM
• Nicole Brnich, PHARMD
• Broad & Lehigh Pharmacy, Inc
• Broad and Snyder Pharmacy P C (Broad and Snyder Pharmacy)
• Broad Health Center Inc.
• Broad St Pharmacy
• Broad Street Braces
• Broad Street Chiropractic & Wellness Center, LLC

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.