904 Prospect Pharmacy Inc
Long Term Care Pharmacy
904 Prospect Ave, Bronx
New York, 10459-3929
718-991-6700 718-874-1378
904 Prospect Pharmacy Inc is a Long Term Care Pharmacy in Bronx, New York. It is located at 904 Prospect Ave, Bronx and it's customer support contact number is 718-991-6700. The authorized person of 904 Prospect Pharmacy Inc is Jacob Jamron who is Ceo of the pharmacy and his contact number is 718-991-6700. 904 Prospect Pharmacy Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
904 Prospect Pharmacy Inc is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Pharmacy Details:
904 Prospect Pharmacy Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | 904 Prospect Pharmacy Inc |
| Type: | Long Term Care Pharmacy |
| Location: | 904 Prospect Ave, Bronx,
New York, 10459-3929 |
| Phone: | 718-991-6700 |
| Fax: | 718-874-1378 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Jacob Jamron |
| Position: | Ceo |
| Contact Number: | 718-991-6700 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1043307242 |
| NPI Enumeration Date: | 07 Oct, 2006 |
| NPI Last Update On: | 30 Jul, 2025 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for 904 Prospect Pharmacy Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Long Term Care Pharmacy | | | Primary | |
| Community/Retail Pharmacy | 027296 | New York | Secondary | |
| Specialty Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2664726 | Medicaid | New York | |
| 2064042 | Other | | Pk |
Medicare Enrollment:
904 Prospect Pharmacy Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 1052512134 | O20100930073664 | 904 Prospect Pharmacy Inc | DME SUPPLIER - PHARMACY |
Products Available:
904 Prospect Pharmacy Inc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Mail Order | • Blood Glucose Monitors & Supplies: Non-mail Order |
| • Canes & Crutches | • Commodes, Urinals, & Bedpans |
| • Diabetic Shoes & Inserts: Prefabricated | • Enteral Nutrients |
| • Heat & Cold Applications | • Nebulizer Equipment & Supplies |
| • Surgical Dressings | • Tracheostomy Supplies |
| • Urological Supplies | • Walkers |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Po Box 740054,
Bronx, New York |
| Zip: | 10474-0001 |
| Phone Number: | 718-991-6700 |
| Fax Number: | 718-874-1378 |
Patients can reach 904 Prospect Pharmacy Inc at
904 Prospect Ave, Bronx, New York or can
call on customer care at 718-991-6700.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.