Healthcare Provider Details

I. General information

NPI: 1114060829
Provider Name (Legal Business Name): RXD PHARMACY OF NJ INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 BROADWAY AVE ELLIS DRUGS
CAMDEN NJ
08103
US

IV. Provider business mailing address

PO BOX 428 RXD PHARMACY OF NJ INC
COLLINGSWOOD NJ
08108-0428
US

V. Phone/Fax

Practice location:
  • Phone: 856-964-1399
  • Fax: 856-964-1239
Mailing address:
  • Phone: 856-858-9292
  • Fax: 856-858-7286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRS03373
License Number StateNJ

VIII. Authorized Official

Name: MR. ROBERT S MILNER
Title or Position: CHARIMAN
Credential:
Phone: 856-577-4577