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Contact Information

158TH STREET NEIGHBORHOOD PHARMACY, LLC
3103 3RD AVE
BRONX, NY10451-4688
 Phone: 718-585-6188
 Fax: 718-585-6653
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for 158TH STREET NEIGHBORHOOD PHARMACY, LLC

NPI # 1215048152
LBN Legal business name 158TH STREET NEIGHBORHOOD PHARMACY, LLC
Authorized official NOAM AVIDAR - (MEMEBER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/31/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
NY License # 026148
NY Medicaid 02519551
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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