Healthcare Provider Details

I. General information

NPI: 1467545897
Provider Name (Legal Business Name): CARLBERT DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 08/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E PALISADE AVE
ENGLEWOOD NJ
07631-2901
US

IV. Provider business mailing address

35 E PALISADE AVE
ENGLEWOOD NJ
07631-2901
US

V. Phone/Fax

Practice location:
  • Phone: 201-569-1345
  • Fax: 201-568-5354
Mailing address:
  • Phone: 201-569-1345
  • Fax: 201-568-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00419300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GILBERT DOMINGUEZ
Title or Position: PIC
Credential: RPH
Phone: 201-569-1365