Healthcare Provider Details

I. General information

NPI: 1528134301
Provider Name (Legal Business Name): LANDMARK DRUG CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 SOMERSET ST
NORTH PLAINFIELD NJ
07060-4774
US

IV. Provider business mailing address

345 SOMERSET ST
NORTH PLAINFIELD NJ
07060-4774
US

V. Phone/Fax

Practice location:
  • Phone: 908-412-9400
  • Fax: 908-757-2228
Mailing address:
  • Phone: 908-412-9400
  • Fax: 908-757-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberRSRS00612300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00612300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00612300
License Number StateNJ

VIII. Authorized Official

Name: MR. ANKAMMA ATTOTI
Title or Position: PHARMACIST IN-CHARGE & DIRECTOR
Credential: MS (PHARMACY) & R.PH
Phone: 908-412-9400