Healthcare Provider Details

I. General information

NPI: 1801985460
Provider Name (Legal Business Name): GELLER'S VILLAGE DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 ELIZABETH AVE
ELIZABETH NJ
07201-2755
US

IV. Provider business mailing address

851 ELIZABETH AVE
ELIZABETH NJ
07201-2755
US

V. Phone/Fax

Practice location:
  • Phone: 908-353-8200
  • Fax: 908-353-7340
Mailing address:
  • Phone: 908-353-8200
  • Fax: 908-353-7340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number3336C0003X
License Number StateNJ

VIII. Authorized Official

Name: MR. NARENDAR REDDY YASA
Title or Position: PRESIDENT
Credential: PHARMACIST
Phone: 908-353-8200