Healthcare Provider Details

I. General information

NPI: 1346210911
Provider Name (Legal Business Name): COMMUNITY DISTRIBUTORS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 ROUTE 9 N
HOWELL NJ
07731-3307
US

IV. Provider business mailing address

800 COTTONTAIL LN
SOMERSET NJ
08873-1227
US

V. Phone/Fax

Practice location:
  • Phone: 732-905-1150
  • Fax: 732-886-1685
Mailing address:
  • Phone: 732-748-8900
  • Fax: 732-868-4172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number6430
License Number StateNJ

VIII. Authorized Official

Name: MR. BARRIE LEVINE
Title or Position: V.P. PHARMACY
Credential: RPH
Phone: 732-748-8900