Healthcare Provider Details

I. General information

NPI: 1447301924
Provider Name (Legal Business Name): MILLSTONE FAMILY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2007
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 MILLSTONE RD # 46
PERRINEVILLE NJ
08535-1214
US

IV. Provider business mailing address

221 MILLSTONE RD # 46
PERRINEVILLE NJ
08535-1214
US

V. Phone/Fax

Practice location:
  • Phone: 732-446-5050
  • Fax: 732-446-6042
Mailing address:
  • Phone: 732-446-5050
  • Fax: 732-446-6042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00619700
License Number StateNJ

VIII. Authorized Official

Name: ANTHONY B DEBLASIO
Title or Position: OWNER
Credential:
Phone: 732-446-5050