Broadway Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054013828 Issued in IL

Legal business name

BROADWAY PHARMACY INC

Doing business as

BROADWAY PHARMACY INC

Practice address

4564 N Broadway St
Chicago, IL 60640-5602

Phone

(773) 271-9727

Fax

(773) 271-8306

NPI assigned

Feb 14, 2007

Organization subpart

No

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

Authorized official

Name

Jayprakash Pandya

Title

President Pharmacist

Phone

(773) 271-9727

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• BROADWAY PHARMACY INC Doing business as

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1396888061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4564 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405602",
            "telephone_number": "773-271-9727",
            "fax_number": "773-271-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4564 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405602",
            "telephone_number": "773-271-9727",
            "fax_number": "773-271-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "PANDYA",
        "authorized_official_first_name": "JAYPRAKASH",
        "authorized_official_title_or_position": "PRESIDENT PHARMACIST",
        "authorized_official_telephone_number": "773-271-9727"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054013828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2021693",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BROADWAY PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Broadie, RN
• Jacob David Broadrick, MSN RN
• Broadway Chiropractic Inc
• Broadway Medical Group
• Broadway Medical Office S C
• Wahab Brobbey, MD
• Rudel Broces
• Beverly Brock, LCPC, CADC
• Marsha Muir Brock, LCPC
• Max Brock

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.