Healthcare Provider Details

I. General information

NPI: 1760926026
Provider Name (Legal Business Name): CADC PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2016
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 ROUTE 15S SUITE 104
LAKE HOPATCONG NJ
07849
US

IV. Provider business mailing address

706 ROUTE 15S SUITE 104
LAKE HOPATCONG NJ
07849
US

V. Phone/Fax

Practice location:
  • Phone: 973-663-2560
  • Fax: 973-663-2440
Mailing address:
  • Phone: 973-663-2560
  • Fax: 973-663-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00704100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUGLAS CABALLERO
Title or Position: OWNER
Credential:
Phone: 201-264-6244