Healthcare Provider Details

I. General information

NPI: 1154336550
Provider Name (Legal Business Name): PARKE-TOWNE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 HESSIAN AVENUE
NATIONAL PARK NJ
08063
US

IV. Provider business mailing address

1010 HESSIAN AVENUE
NATIONAL PARK NJ
08063
US

V. Phone/Fax

Practice location:
  • Phone: 856-845-5225
  • Fax:
Mailing address:
  • Phone: 856-845-5225
  • Fax: 856-845-0350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberNJ0885
License Number StateNJ

VIII. Authorized Official

Name: STANLEY S BAILER
Title or Position: OWNER
Credential: BS
Phone: 856-845-5225