South Broad Drugs INC
Pharmacy, Community/Retail Pharmacy in Newark, NJ. Organization (NPI-2).
NPI number1528089596
StatusActive
Last updated in NPPESApr 20, 2011
Details
- NPI
- 1528089596
- Entity type
- Organization (NPI-2)
- Legal business name
- South Broad Drugs INC
- Organization subpart
- No
- Enumeration date
- Jul 22, 2006
- Last updated
- Apr 20, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 28RS00358500 | NJ | Yes |
Other names
- South Broad Drugs (Doing Business As)
Practice location
1094 Broad StNewark, NJ 07114-2004
Phone 973-824-3929 · Fax 973-824-9446
Mailing address
1094 Broad StNewark, NJ 07114-2004
Phone 973-824-3929 · Fax 973-824-9446
Authorized official
Vinodrai Shah
Supervising Rph
9738243929
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