Healthcare Provider Details

I. General information

NPI: 1497853832
Provider Name (Legal Business Name): EMERSON PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 EMERSON PLAZA WEST
EMERSON NJ
07630-1826
US

IV. Provider business mailing address

4 EMERSON PLAZA WEST
EMERSON NJ
07630-1826
US

V. Phone/Fax

Practice location:
  • Phone: 201-262-4999
  • Fax: 201-262-3870
Mailing address:
  • Phone: 201-262-4999
  • Fax: 201-262-3870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5220
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. KURT SAMUEL D'ALESSANDRO
Title or Position: PRESIDENT
Credential: RPH
Phone: 201-262-4999