South Fulton Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034357 Issued in NY

Legal business name

SOUTH FULTON PHARMACY INC

Doing business as

South Fulton Pharmacy Inc.

Practice address

301 S Fulton Ave
Mount Vernon, NY 10553-1715

Phone

(914) 667-7772

Fax

(914) 667-7774

NPI assigned

Apr 6, 2016

Organization subpart

No

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

Authorized official

Name

Aymen JaberNPI 1255600466

Title

President

Phone

(914) 667-7772

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• South Fulton Pharmacy Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aymen Hisham Jaber, PHARMD

  • Pharmacist
  • Brooklyn, NY
  • NPI 1255600466
  NPD Authorized official

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1558725499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S FULTON AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531715",
            "telephone_number": "914-667-7772",
            "fax_number": "914-667-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S FULTON AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105531715",
            "telephone_number": "914-667-7772",
            "fax_number": "914-667-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FULTON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "JABER",
        "authorized_official_first_name": "AYMEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-667-7772"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159434",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Fulton Pharmacy Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ursula Sosa
• Christina Soto, CERTIFIED SCHOOL PSY
• Victoria Elena Souffrant, NUTRITIONIST
• Sound Shore Pharmacy Inc
• Sound Shore Pharmacy, Inc
• Southern Westchester Pediatrics
• SP Womens Health NP Services PLLC
• Alaisia Spence
• Rosalyn Dorothy Spence
• Yvonne Spencer

• Community/Retail Pharmacy in Mount Vernon, NY
• Providers in Mount Vernon, 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 Jan 18, 2017; 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.