3340 Broadway Pharmacy 2 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

027032 Issued in NY

Legal business name

3340 BROADWAY PHARMACY 2 INC

Doing business as

3340 Broadway Pharmacy

Practice address

3621 Broadway
New York, NY 10031-2518

Phone

(212) 926-9800

Fax

(212) 926-2228

NPI assigned

Oct 20, 2006

Last updated

Oct 27, 2014By 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

Edwin PerezNPI 1649312794

Title

President

Phone

(212) 926-9800

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• 3340 BROADWAY PHARMACY Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edwin Perez

  • Pharmacist
  • New York, NY
  • NPI 1649312794
  NPD Authorized official
• Alex Chu

  • Pharmacist
  • New York, NY
  • NPI 1740838762
  NPD (past)
• Goverdhan Sandadi Reddy, R.PH

  • Pharmacist
  • New York, NY
  • NPI 1366690661
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1427130210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100312518",
            "telephone_number": "212-926-9800",
            "fax_number": "212-926-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100312518",
            "telephone_number": "212-926-9800",
            "fax_number": "212-926-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3340 BROADWAY PHARMACY 2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-926-9800"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "027032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02648108",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2063653",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "3340 BROADWAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 27, 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.