Provider Demographics
NPI:1134543671
Name:EXPRESS CARE PHARMACY, LLC
Entity type:Organization
Organization Name:EXPRESS CARE PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-618-7525
Mailing Address - Street 1:15 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-5801
Mailing Address - Country:US
Mailing Address - Phone:718-618-7525
Mailing Address - Fax:718-618-7526
Practice Address - Street 1:15 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5801
Practice Address - Country:US
Practice Address - Phone:718-618-7525
Practice Address - Fax:718-618-7526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0324663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy