Healthcare Provider Details

I. General information

NPI: 1427166784
Provider Name (Legal Business Name): ELVIRA J SALAS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 KNOLLCROFT RD
LYONS NJ
07939-5001
US

IV. Provider business mailing address

61 KINNAN WAY
BASKING RIDGE NJ
07920-1830
US

V. Phone/Fax

Practice location:
  • Phone: 908-647-0180
  • Fax:
Mailing address:
  • Phone: 908-953-9735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28R101629900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: