Healthcare Provider Details

I. General information

NPI: 1407867922
Provider Name (Legal Business Name): EXPRESS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N OLDEN AVE
EWING NJ
08638-3108
US

IV. Provider business mailing address

1801 N OLDEN AVE
EWING NJ
08638-3108
US

V. Phone/Fax

Practice location:
  • Phone: 609-538-8600
  • Fax: 609-538-0500
Mailing address:
  • Phone: 609-538-8600
  • Fax: 609-538-0500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRS00618200
License Number StateNJ

VIII. Authorized Official

Name: DINESH CHAUDHARI
Title or Position: PRESIDENT
Credential:
Phone: 609-538-8600