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NPI 1043307242

OrganizationActive

904 Prospect Pharmacy Inc

NPI 1043307242 · Long Term Care Pharmacy · Bronx, NY

Provider details

NPI number: 1043307242
Entity type: Organization
Primary specialty: Long Term Care PharmacySuppliers
Authorized official: Jacob Jamron, Ceo
License: 027296 (NY)

Practice location

904 Prospect Ave

Bronx, NY 10459-3929

Phone: (718) 991-6700

Fax: (718) 874-1378

More NY providers

Mailing address

Po Box 740054

Bronx, NY 10474-0001

Registry dates

Enumerated: 2006-10-07
Last updated: 2025-07-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

904 Prospect Pharmacy Inc — NPI 1043307242, Bronx, NY | NPI Central