Healthcare Provider Details

I. General information

NPI: 1477251064
Provider Name (Legal Business Name): ACA PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 E MAIN ST
OCEANPORT NJ
07757-1145
US

IV. Provider business mailing address

271 E MAIN ST
OCEANPORT NJ
07757-1145
US

V. Phone/Fax

Practice location:
  • Phone: 201-780-0976
  • Fax:
Mailing address:
  • Phone: 732-542-8607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: IBRAM ATALLA
Title or Position: PARTNER
Credential:
Phone: 732-542-8607