3890 Broadway Pharmacy IV, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

027458 Issued in NY

Legal business name

3890 BROADWAY PHARMACY IV, INC.

Practice address

3898 Broadway
New York, NY 10032

Phone

(212) 568-0975

Fax

(212) 568-0976

NPI assigned

Nov 11, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Haydee Meregildo

Title

Owner

Phone

(212) 568-0975

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1790766103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3898 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-568-0975",
            "fax_number": "212-568-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3898 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "212-568-0975",
            "fax_number": "212-568-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3890 BROADWAY PHARMACY IV, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "MEREGILDO",
        "authorized_official_first_name": "HAYDEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-568-0975",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "027458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.