Organization
SOUTHERN PHARMACY INC
Active
Other names
Southern Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ANAR YUSUFOV (PRESIDENT)
(347) 918-9300
Entity
Organization
Contact information
Practice address
1301 SOUTHERN BLVD, BRONX, NY 10459-1504
(347) 918-9300
(347) 918-9344
Mailing address
1301 SOUTHERN BLVD, BRONX, NY 10459-1504
(347) 918-9300
(347) 918-9344
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
036580
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177711
PK
—
Enumeration date
05/03/2018
Last updated
07/19/2018
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