Provider Demographics
NPI:1386152858
Name:SIDON LLC
Entity type:Organization
Organization Name:SIDON LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDOLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:REDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-864-7600
Mailing Address - Street 1:901 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5530
Mailing Address - Country:US
Mailing Address - Phone:201-864-7600
Mailing Address - Fax:201-864-7602
Practice Address - Street 1:901 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5530
Practice Address - Country:US
Practice Address - Phone:201-864-7600
Practice Address - Fax:201-864-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy