Broadway Apothecary Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BROADWAY APOTHECARY INC.

Practice address

779 Broadway
New York, NY 10003-6804

Phone

(212) 961-6681

Fax

(917) 265-8404

NPI assigned

Oct 28, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Azar Kamkhehji, RPH

Title

President

Phone

(212) 961-6681

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572220800000",
    "number": "1154964674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036804",
            "telephone_number": "212-961-6681",
            "fax_number": "917-265-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036804",
            "telephone_number": "212-961-6681",
            "fax_number": "917-265-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY APOTHECARY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A",
        "authorized_official_last_name": "KAMKHEHJI",
        "authorized_official_first_name": "AZAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-961-6681",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Broad, MD
• Erika Broad, LMSW
• Christine Broadaway, NP
• Crystal Broadhead
• Alexandra L Broadus, PHARMD
• Broadway Cardiopulmonary, P.C.
• Broadway Chiropractic and Wellness
• Broadway Chiropractic Associates
• Broadway Denatl Care, PC
• Broadway Dental Office, P.C

• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.