Healthcare Provider Details

I. General information

NPI: 1760424428
Provider Name (Legal Business Name): HUNTERDON REGIONAL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR 1ST FLOOR
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

2100 WESCOTT DR 1ST FLOOR
FLEMINGTON NJ
08822-4603
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6586
  • Fax: 908-788-6587
Mailing address:
  • Phone: 908-788-6586
  • Fax: 908-788-6587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00620500
License Number StateNJ

VIII. Authorized Official

Name: DR. CHARLY I NASSER
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 732-788-6586