Organization
ANAYA I INC
Active
Other names
Cannon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANKIT DESAI (MANAGER)
(347) 470-6061
Entity
Organization
Contact information
Practice address
23 S MAIN ST, FREEPORT, NY 11520-3603
(516) 623-2222
(516) 378-0041
Mailing address
23 S MAIN ST, FREEPORT, NY 11520-3603
(516) 623-2222
(516) 378-0041
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034914
NY
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04590112
—
NY
01
—
2160888
PK
—
Enumeration date
06/20/2016
Last updated
01/25/2023
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