Healthcare Provider Details

I. General information

NPI: 1720270267
Provider Name (Legal Business Name): INSERRA SUPERMAKETS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 E MAIN ST
RAMSEY NJ
07446-1924
US

IV. Provider business mailing address

27 E MAIN ST
RAMSEY NJ
07446-1924
US

V. Phone/Fax

Practice location:
  • Phone: 201-327-0033
  • Fax:
Mailing address:
  • Phone: 201-327-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CARY LAMPERT
Title or Position: DIRECTOR OF PHARMACY
Credential: RP
Phone: 201-529-5927