Healthcare Provider Details

I. General information

NPI: 1538763685
Provider Name (Legal Business Name): BARBARA OBRIEN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2020
Last Update Date: 11/29/2020
Certification Date: 11/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2037 WEST BLVD
MALAGA NJ
08328-4443
US

IV. Provider business mailing address

2037 WEST BLVD
MALAGA NJ
08328-4443
US

V. Phone/Fax

Practice location:
  • Phone: 856-694-3951
  • Fax:
Mailing address:
  • Phone: 856-694-3951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02721400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: