Provider Demographics
NPI:1114398237
Name:5999 BROADWAY INC.
Entity Type:Organization
Organization Name:5999 BROADWAY INC.
Other - Org Name:PHARMCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALITSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:201-491-9699
Mailing Address - Street 1:5999 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-4101
Mailing Address - Country:US
Mailing Address - Phone:718-601-6000
Mailing Address - Fax:
Practice Address - Street 1:5999 BROADWAY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-4101
Practice Address - Country:US
Practice Address - Phone:718-601-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-15
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherEIN NUMBER