| NPI | 1316043573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HOST Owner 201-436-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NJ 28RS00219000) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: NJ 28RS00219000) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NJ 28RS00219000) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2023-12-19 |