La Hispana on Broadway Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

029488 Issued in NY

Legal business name

LA HISPANA ON BROADWAY PHARMACY LLC

Practice address

3890 Broadway
New York, NY 10032-1509

Phone

(212) 568-6878

Fax

(212) 568-6877

NPI assigned

Jul 27, 2009

Organization subpart

No

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

Authorized official

Name

Charles Seide

Title

Partner

Phone

(516) 375-4464

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• La Hispana on Broadway Pharmacy, LLC Doing business as

Locations

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1710117627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321509",
            "telephone_number": "212-568-6878",
            "fax_number": "212-568-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321509",
            "telephone_number": "212-568-6878",
            "fax_number": "212-568-6877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA HISPANA ON BROADWAY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "SEIDE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "516-375-4464"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "029488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3361932",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Hispana on Broadway Pharmacy, LLC",
            "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 Aug 18, 2009; 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.