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General NPI Number Information
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NPI Number | 1265813620
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Entity Type | Organization
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Legal Business Name | 520 FRANKLIN AVENUE PHARMACY
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 03/16/2017
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Provider Practice Location Address
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Address Line | 520 FRANKLIN AVE STE 103
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City | GARDEN CITY
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State | NY
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Zip | 11530-5814
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Country | US
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Telephone | 516-280-7960
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Fax | 516-280-7962
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Provider Business Mailing Address
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Address Line | 520 FRANKLIN AVE STE 103
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City | GARDEN CITY
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State | NY
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Zip | 11530-5814
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Country | US
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Telephone | 516-280-7960
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Fax | 516-280-7962
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | JANAKIRAM AJJARAPU
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Credential | RPH
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Telephone | 267-888-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 033760
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License Number State | NY
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