Provider Demographics
NPI:1497366025
Name:SOBRO PHARMACY INC.
Entity Type:Organization
Organization Name:SOBRO PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANAR
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSUFOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-721-9292
Mailing Address - Street 1:2550 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-1261
Mailing Address - Country:US
Mailing Address - Phone:347-721-9292
Mailing Address - Fax:718-993-3177
Practice Address - Street 1:2550 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1261
Practice Address - Country:US
Practice Address - Phone:347-721-9292
Practice Address - Fax:718-993-3177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy