| NPI | 1396465407 |
|---|---|
| Doing Business As | BROAD STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JAMAL ALI Manager 347-464-1533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |