Southern Boulevard Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SOUTHERN BOULEVARD PHARMACY INC

Practice address

1767 Southern Blvd
Bronx, NY 10460-4801

Phone

(718) 975-0988

Fax

(718) 975-0989

NPI assigned

Nov 8, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Ahsan Nadeem

Title

President

Phone

(646) 877-1190

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1437814035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1767 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604801",
            "telephone_number": "718-975-0988",
            "fax_number": "718-975-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604801",
            "telephone_number": "718-975-0988",
            "fax_number": "718-975-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BOULEVARD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "NADEEM",
        "authorized_official_first_name": "AHSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-877-1190",
        "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": []
}

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• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.