904 Prospect Pharmacy Inc
904 Prospect Pharmacy Inc is a healthcare organization registered as Long Term Care Pharmacy in Bronx, NY, holding Type 2 (organization) NPI 1043307242 since 2006. The authorized official on file is Jacob Jamron, Ceo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1043307242 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | 904 Prospect Pharmacy Inc |
| Other name | <Unavail> |
| Practice address | 904 PROSPECT AVE, Bronx, NY, 10459 |
| Phone | 7189916700 |
| Fax | 7188741378 |
| Enumeration date | 2006-10-07 |
| Last updated in NPPES | 2025-07-30 |
Authorized official
| Name | Jacob Jamron |
|---|---|
| Title | Ceo |
| Phone | 7189916700 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0003X | Community/Retail Pharmacy | Secondary | 027296 | NY |
| 3336S0011X | Specialty Pharmacy | Secondary | — | — |
| 3336L0003X | Long Term Care Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2664726 | Medicaid | NY | — |
| 2064042 | Other | — | PK |
Copy-ready billing details
Provider: 904 Prospect Pharmacy Inc NPI: 1043307242 Taxonomy: 3336L0003X (Long Term Care Pharmacy) Address: 904 PROSPECT AVE, Bronx, NY, 10459
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1841309614 | Jacob Jamron | Individual | Pharmacist | Bronx, NY |
| 1528215597 | Leah Kang | Individual | Pharmacist | Bronx, NY |
| 1043468218 | Jong Dae Lee | Individual | Pharmacist | Bronx, NY |
| 1790039006 | Kathleen Mc Laughlin | Individual | Pharmacist | Bronx, NY |
Verify this record
Cross-check NPI 1043307242 against the authoritative CMS record: view 904 Prospect Pharmacy Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is 904 Prospect Pharmacy Inc located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-07-30.