Sullyfield Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SULLYFIELD PHARMACY LLC

Doing business as

Sullyfield Pharmacy

Practice address

14102 Sullyfield Cir Ste 150B
Chantilly, VA 20151-1610

Phone

(703) 495-3410

NPI assigned

Jan 24, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Hany Farag

Title

President

Phone

(703) 495-3410

Specialties & licenses 1

Addresses

Other names 1

• SULLYFIELD PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1265996169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14102 SULLYFIELD CIR STE 150B",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511610",
            "telephone_number": "703-495-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14102 SULLYFIELD CIR STE 150B",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511610",
            "telephone_number": "703-495-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLYFIELD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "FARAG",
        "authorized_official_first_name": "HANY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-495-3410",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SULLYFIELD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.