Southbronxrxinc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

033226 Issued in NY

Legal business name

SOUTHBRONXRXINC

Practice address

1650 Grand Concourse
Bronx, NY 10457-7606

Phone

(718) 538-3385

Fax

(718) 538-3384

NPI assigned

Nov 18, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Ajantha Bommareddy, OWNER

Title

President

Phone

(201) 400-2286

Specialties & licenses 1

Addresses

Other identifiers 1

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

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1164828125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-538-3385",
            "fax_number": "718-538-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-538-3385",
            "fax_number": "718-538-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHBRONXRXINC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-18",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "BOMMAREDDY",
        "authorized_official_first_name": "AJANTHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-400-2286",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "033226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE BOARD OF PHARMACY",
            "identifier": "033226",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Bronx Mental Health Council, Inc.
• South Bronx Orthodontics
• South Bronx Transportation
• South Medical Services Ny PC
• South Westchester Vein & Vascular PLLC
• Southern Boulevard Pharmacy Inc
• Southern Eye Care Inc
• Southern Pharmacy Inc
• Southern Vision Care PC.
• Southern Wellcare Medical PC

• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, 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 Sep 20, 2016; 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.