Healthcare Provider Details

I. General information

NPI: 1639523996
Provider Name (Legal Business Name): A & K PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 BROADWAY
NORTH BERGEN NJ
07047
US

IV. Provider business mailing address

150 E BOCA RATON ROAD
BOCA RATON FL
33432
US

V. Phone/Fax

Practice location:
  • Phone: 201-854-4800
  • Fax: 201-854-1518
Mailing address:
  • Phone: 561-288-3655
  • Fax: 201-854-1518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00548900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SALVATORE LANTIERI
Title or Position: MANAGER
Credential:
Phone: 561-288-3655