Broadway Medical Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY48442 Issued in CA

Legal business name

BROADWAY MEDICAL PHARMACY

Practice address

1673 W Broadway Ste 1
Anaheim, CA 92802-1109

Phone

(714) 772-3630

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Van Thi Le

Title

Pharmacist in Charge/Owner

Phone

(714) 772-3630

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Broadway Medical Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Broadway Medical Pharmacy

  • Pharmacist
  • Anaheim, CA
  • NPI 1154461085
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Van P Le

  • Pharmacist
  • Anaheim, CA
  • NPI 1285707604
  NPD (past)

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1801072749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 W BROADWAY STE 1",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928021109",
            "telephone_number": "714-772-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 W BROADWAY STE 1",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928021109",
            "telephone_number": "714-772-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY MEDICAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE/OWNER",
        "authorized_official_telephone_number": "714-772-3630"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY48442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA484420",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Janelly Brito
• Rubi Brito
• Mary A Brittain
• BRMP Professional Medical Corporation
• Broadway Medical Pharmacy
• Jacqueline D Brock, LMFT
• Brodsky Dermatology and Skin Cancer, PC
• Scott Wayne Bronstein, MD
• Jasmine Brooks
• Lynette Broom, RD

• Community/Retail Pharmacy in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.