MEDICARE: VERONA PHARMACY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	RS00669000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	RS00669000	OTHER	NJ	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1083839468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERONA PHARMACY INC.

Provider Business Mailing Address
First Line	:	144 BLOOMFIELD AVE
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-2711
Country	:	US
Telephone Number	:	973-857-7710
Fax Number	:	973-857-7730

Provider Business Practice Location Address
First Line	:	144 BLOOMFIELD AVE
Second Line	:
City	:	VERONA
State	:	NJ
Zip	:	07044-2711
Country	:	US
Telephone Number	:	973-857-7710
Fax Number	:	973-857-7730

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ASHRAF ASHAMALLA
Credential	:	RPH
Telephone Number	:	201-993-0978

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	03/07/2023

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Directions to “VERONA PHARMACY INC. ” Practice Location

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