NPI | 1396888061 |
---|---|
Doing Business As | BROADWAY PHARMACY INC |
Entity Type | Organization |
Authorized Contact | JAYPRAKASH PANDYA President Pharmacist 773-271-9727 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054013828) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2007-02-14 |
Last Update Date | 2014-05-14 |