Healthcare Provider Details

I. General information

NPI: 1962400804
Provider Name (Legal Business Name): THE CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 ROUTE 70 E STE U-104
CHERRY HILL NJ
08003-2150
US

IV. Provider business mailing address

1930 ROUTE 70 E STE U-104
CHERRY HILL NJ
08003-2150
US

V. Phone/Fax

Practice location:
  • Phone: 856-489-3256
  • Fax: 856-489-3258
Mailing address:
  • Phone: 856-489-3256
  • Fax: 856-489-3258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28R500640100
License Number StateNJ

VIII. Authorized Official

Name: DR. RICHARD C FORDHAM
Title or Position: OWNER
Credential: PHARM D
Phone: 856-489-3256