Provider Demographics
NPI:1326729781
Name:SOUTH BRONX INC
Entity Type:Organization
Organization Name:SOUTH BRONX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SOVEIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COBOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-201-9061
Mailing Address - Street 1:1230 METCALF AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472
Mailing Address - Country:US
Mailing Address - Phone:646-201-9061
Mailing Address - Fax:646-201-9062
Practice Address - Street 1:1230 METCALF AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472
Practice Address - Country:US
Practice Address - Phone:646-201-9061
Practice Address - Fax:646-201-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy