Healthcare Provider Details

I. General information

NPI: 1144654930
Provider Name (Legal Business Name): PHARMCARE USA OF EDISON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 NEWFIELD AVE SUITE A AND B
EDISON NJ
08837-3824
US

IV. Provider business mailing address

PO BOX 12
HYDRO OK
73048-0012
US

V. Phone/Fax

Practice location:
  • Phone: 732-733-2354
  • Fax: 732-346-1999
Mailing address:
  • Phone: 405-663-4111
  • Fax: 405-663-4114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number028765
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00675800
License Number StateNJ

VIII. Authorized Official

Name: KENT ABBOTT
Title or Position: PRESIDENT
Credential:
Phone: 405-663-4111