1336429778 NPI number — BRIARWOOD PHARMACY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336429778 NPI number — BRIARWOOD PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIARWOOD PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BRIARWOOD PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336429778
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2450 KUSER RD STE G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08690-3359
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-587-2838
Provider Business Mailing Address Fax Number:
609-587-1811

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2450 KUSER RD STE G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08690-3359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-587-2838
Provider Business Practice Location Address Fax Number:
609-587-1811
Provider Enumeration Date:
08/17/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
HARSHAD
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST
Authorized Official Telephone Number:
609-610-7296

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  28RS00713900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3198050 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".