Bradhurst Specialty Pharmacy Inc
Organization Active NPI Pharmacy · Hawthorne, NY
NPI 1740465814 · NPPES record last updated Dec 3, 2010
Key facts
- NPI
- 1740465814
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 028582 (NY)
- Legal business name
- BRADHURST SPECIALTY PHARMACY INC
- Practice address
- 19 Bradhurst Ave
Suite L1
Hawthorne, NY 10532-2140 - Phone
- (914) 345-0070
- Fax
- (914) 345-0211
- NPI assigned
- Jan 8, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. James Melancon
- Title
- Vice President
- Phone
- (917) 449-6939
National Provider Directory
Locations
19 Bradhurst Ave
Ste L1
Hawthorne, NY 10532
Phone (914) 345-0070
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 028582 | NY | Yes |
Addresses
Primary practice location
19 Bradhurst Ave
Suite L1
Hawthorne, NY 10532-2140
Mailing address
10050 Crosstown Cir
Suite 300
Eden Prairie, MN 55344-3348
Phone (952) 979-3680
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02968394 | Medicaid | NY | |
| 1740465814 | Medicaid | CT | |
| 0184781 | Medicaid | NJ |
Other names
- The Atrium Pharmacy
Other providers in Hawthorne, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.