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904 PROSPECT PHARMACY INC
NPI 1043307242
Pharmacy - Long Term Care Pharmacy in Bronx, NY

Active since October 07, 2006
904 PROSPECT AVE, BRONX, NY 10459(718) 991-6700(718) 874-1378 Get Directions Write a Review

NPPES record last updated: July 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 29, 2022, Jan 23, 2020, Jan 14, 2020 and 4 more (7 updates tracked since 2016).

About 904 Prospect Pharmacy Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

904 PROSPECT PHARMACY INC (NPI 1043307242), doing business as Boca Pharmacy, is a healthcare organization registered as a long term care pharmacy in Bronx, New York and active in the NPI registry since October 2006. The organization lists Jacob Jamron, Ceo, as its authorized official.

NPPES Registry Identity

NPI1043307242
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business Name904 PROSPECT PHARMACY INC
Location Address904 PROSPECT AVEBronx, NY 10459-3929
Mailing AddressPo Box 740054Bronx, NY 10474-0001 · (718) 991-6700 · Fax (718) 874-1378
Phone(718) 991-6700
Fax(718) 874-1378
Organization SubpartNo
Authorized OfficialJacob JamronCeo · (718) 991-6700
Enumeration DateOctober 7, 2006
Last NPPES UpdateJuly 30, 20257 updates tracked since enumeration
NPPES CertifiedJuly 30, 2025
✔ NPI 1043307242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X · License 027296 (NY)
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X
904 PROSPECT AVE, Bronx, NY 10459
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Other Names 1

Doing Business AsBoca Pharmacy

Other Identifiers 2

Medicaid2664726NY
Other2064042Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 14

Medicare supplier enrollment and the product categories 904 Prospect Pharmac carries, from the Medicare DMEPOS supplier directory.

904 Prospect Pharmac

DMEPOS supplier · Bronx, NYOperated by 904 Prospect Pharmacy Inc
⋮

Does not accept Medicare assignment

904 Prospect Pharmac has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20578379
Medicare Participant SinceJuly 29, 2005
Supplier Location904 Prospect AveBronx, NY 10459
Phone(718) 991-6700
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Blood Glucose Monitors/Supplies (Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Heat & Cold Applications
Heat therapy, Cold therapy, Heating pads
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JONG DAE LEE
Pharmacist
904 PROSPECT AVE
BRONX, NY 10459
Bronx County (718) 991-6700
MS. LEAH KANG RPH
Pharmacist
904 PROSPECT AVE
BRONX, NY 10459
Bronx County (917) 941-2780
DR. KATHLEEN MC LAUGHLIN PHARMD
Pharmacist
904 PROSPECT AVE
BRONX, NY 10459
Bronx County (718) 991-6700
MR. JACOB JAMRON
Pharmacist
904 PROSPECT AVE
BRONX, NY 10459
Bronx County (718) 991-6700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 904 Prospect Pharmacy Inc's NPI number?

The NPI number for 904 Prospect Pharmacy Inc is 1043307242. It was assigned to this organization in the NPPES registry on October 7, 2006. The provider is doing business as Boca Pharmacy.

Where is 904 Prospect Pharmacy Inc located?

904 Prospect Pharmacy Inc is located at 904 Prospect Ave, Bronx, NY 10459. The listed phone number is (718) 991-6700.

What is 904 Prospect Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does 904 Prospect Pharmacy Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, 904 Prospect Pharmac does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does 904 Prospect Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 42 other insurers list 904 Prospect Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for 904 Prospect Pharmacy Inc was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.