Healthcare Provider Details

I. General information

NPI: 1851374490
Provider Name (Legal Business Name): HILLCREST PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6012 WESTFIELD AVE
PENNSAUKEN NJ
08110-1720
US

IV. Provider business mailing address

6012 WESTFIELD AVE
PENNSAUKEN NJ
08110-1720
US

V. Phone/Fax

Practice location:
  • Phone: 856-663-0700
  • Fax:
Mailing address:
  • Phone: 856-663-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number28RS00378600
License Number StateNJ

VIII. Authorized Official

Name: MR. DILESH RAMESH PATEL
Title or Position: CHIEF PHARMACIST
Credential: R.P
Phone: 856-663-0700