Organization
SOUTH FULTON PHARMACY INC
Active
Other names
South Fulton Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
AYMEN JABER (PRESIDENT)
(914) 667-7772
Entity
Organization
Contact information
Practice address
301 S FULTON AVE, MOUNT VERNON, NY 10553-1715
(914) 667-7772
(914) 667-7774
Mailing address
301 S FULTON AVE, MOUNT VERNON, NY 10553-1715
(914) 667-7772
(914) 667-7774
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
034357
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159434
PK
—
Enumeration date
04/06/2016
Last updated
01/18/2017
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