Southern Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

036580 Issued in NY

Legal business name

SOUTHERN PHARMACY INC

Doing business as

Southern Pharmacy Inc.

Practice address

1301 Southern Blvd
Bronx, NY 10459-1504

Phone

(347) 918-9300

Fax

(347) 918-9344

NPI assigned

May 3, 2018

Last updated

Jul 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anar Yusufov

Title

President

Phone

(347) 918-9300

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Southern Pharmacy Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1518456623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104591504",
            "telephone_number": "347-918-9300",
            "fax_number": "347-918-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104591504",
            "telephone_number": "347-918-9300",
            "fax_number": "347-918-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "YUSUFOV",
        "authorized_official_first_name": "ANAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-918-9300"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "036580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177711",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Pharmacy Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Westchester Vein & Vascular PLLC (Swift Vein and Vascular)
• Southbronxrxinc
• Southern Boulevard Pharmacy Inc
• Southern Eye Care Inc
• Southern Eyes Inc
• Southern Vision Care PC.
• Southern Wellcare Medical PC
• Southern Westchester Diabetes, PC
• William N Southern, MD
• Cristina Souza, MS, PT

• 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 Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.