Broadway Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00749800 Issued in NJ

Legal business name

BROADWAY PHARMACY INC.

Practice address

7211 Broadway
North Bergen, NJ 07047-5736

Phone

(201) 766-9300

Fax

(201) 766-9298

NPI assigned

Jul 27, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Avelino Jesus Avelenda, R.PH.

Title

Owner/President/Rpic

Phone

(201) 766-9300

Specialties & licenses 1

Addresses

Other names 1

• Broadway Pharmacy Doing business as

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1447703236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 BROADWAY",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475736",
            "telephone_number": "201-766-9300",
            "fax_number": "201-766-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 BROADWAY",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475736",
            "telephone_number": "201-766-9300",
            "fax_number": "201-766-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "AVELENDA",
        "authorized_official_first_name": "AVELINO",
        "authorized_official_middle_name": "JESUS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/RPIC",
        "authorized_official_telephone_number": "201-766-9300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00749800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Braincore of North Bergen
• Braincore of North Bergen
• Brianna Braithwaite, MD
• Steven Wayne Braunstein, M.D.
• Michelle Brito, NURSE PRACTITIONER
• Broadway Spine Care
• Brian Brutzman, BCBA
• John Buco, PT
• Adolfo Bueno, DMD
• Audrey Bui

• Community/Retail Pharmacy in North Bergen, NJ
• Providers in North Bergen, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.