Broadway Pharmacy

LBN: Jeluca Pharmacy Corp
Broadway Pharmacy is an health care organization with primary practice located at 811 N Broadway , White Plains NY 10603-2400. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Jeluca Pharmacy Corp can be contacted via phone (914) 949-6100, or through Mirra, Jerry via phone (914) 949-6100.

Contact Information

Primary practice address
811 N Broadway White Plains NY 10603-2400
Phone: (914) 949-6100
Fax: (914) 949-8630
Website:
Map and Directions
Authorized official contact:
Name: Mirra, Jerry
Phone: (914) 949-6100

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 026254 New York

Profile Details

NPI number 1467559385
LBN Legal business name Jeluca Pharmacy Corp
DBA Doing business as Broadway Pharmacy
Authorized official Mirra, Jerry
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Mar 23rd, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467559385 NPPES
New York MEDICAID 02459465
New York Other 3334771

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