| NPI | 1225130354 |
|---|---|
| Doing Business As | FOURTH AVENUE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | AYUSH GAJERA Pharmacist 973-483-3872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NJ 28RS00335200) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2017-04-19 |