Healthcare Provider Details

I. General information

NPI: 1417095613
Provider Name (Legal Business Name): MAX DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 PARK AVE
PATERSON NJ
07504-1532
US

IV. Provider business mailing address

506 PARK AVE
PATERSON NJ
07504-1532
US

V. Phone/Fax

Practice location:
  • Phone: 973-279-4600
  • Fax:
Mailing address:
  • Phone: 973-279-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00648000
License Number StateNJ

VIII. Authorized Official

Name: MISS JANICE DE HOMBRE
Title or Position: MANAGER
Credential:
Phone: 973-279-4600