Provider Demographics
NPI:1760893309
Name:SOUTH FRANKLIN ENTERPRISES INC
Entity Type:Organization
Organization Name:SOUTH FRANKLIN ENTERPRISES INC
Other - Org Name:ANEDDONA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MEDIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAMMUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-548-0663
Mailing Address - Street 1:224 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-6115
Mailing Address - Country:US
Mailing Address - Phone:516-292-2155
Mailing Address - Fax:516-292-2188
Practice Address - Street 1:224 S FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-6115
Practice Address - Country:US
Practice Address - Phone:516-292-2155
Practice Address - Fax:516-292-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0326013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7203150001Medicare NSC