MEDICARE: UNION CITY PHARMACY

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	333600000X	Pharmacy	28RS00717500	NJ

General Provider Information

NPI Number	:	1952672859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION CITY PHARMACY

Provider Business Mailing Address
First Line	:	3214 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-3935
Country	:	US
Telephone Number	:	201-250-8290
Fax Number	:	201-250-8291

Provider Business Practice Location Address
First Line	:	3214 BERGENLINE AVE
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-3935
Country	:	US
Telephone Number	:	201-250-8290
Fax Number	:	201-250-8291

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	TECK GAN
Credential	:
Telephone Number	:	201-250-8250

Provider Enumeration Date	:	01/24/2012
Last Update Date	:	01/24/2012

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Directions to “UNION CITY PHARMACY ” Practice Location

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