Healthcare Provider Details

I. General information

NPI: 1164585279
Provider Name (Legal Business Name): RICHARD G. RUMAGE JR. RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 NEWFIELD AVE STE B
EDISON NJ
08837-3824
US

IV. Provider business mailing address

113 RIVER RD APT B3
NUTLEY NJ
07110-3520
US

V. Phone/Fax

Practice location:
  • Phone: 732-346-1333
  • Fax: 732-346-1999
Mailing address:
  • Phone: 973-542-0650
  • Fax: 732-346-1999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02317500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20049615
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: