Healthcare Provider Details

I. General information

NPI: 1235378761
Provider Name (Legal Business Name): TEXAS ROAD APPLEGARTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 APPLEGARTH RD
MONROE NJ
08831-3733
US

IV. Provider business mailing address

355 APPLEGARTH RD
MONROE NJ
08831-3733
US

V. Phone/Fax

Practice location:
  • Phone: 609-235-9368
  • Fax: 609-235-9399
Mailing address:
  • Phone: 609-235-9368
  • Fax: 609-235-9399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00687700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER SOCHA
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 609-235-9368