Healthcare Provider Details
I. General information
NPI: 1326030610
Provider Name (Legal Business Name): DRUG FAIR GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2005
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27 S MAIN ST
MANVILLE NJ
08835-1801
US
IV. Provider business mailing address
800 COTTONTAIL LN
SOMERSET NJ
08873-1227
US
V. Phone/Fax
- Phone: 908-722-8400
- Fax: 908-722-1443
- Phone: 732-748-8900
- Fax: 732-868-4172
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 5059 |
| License Number State | NJ |
VIII. Authorized Official
Name: MR.
EDWARD
G
MCGINLEY
Title or Position: V.P. PHARMACY
Credential: R.PH.
Phone: 732-748-8900