Healthcare Provider Details

I. General information

NPI: 1063645331
Provider Name (Legal Business Name): RANJITH KUMAR BOMPELLI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 E BROADWAY
SALEM NJ
08079-1108
US

IV. Provider business mailing address

228 E BROADWAY
SALEM NJ
08079-1108
US

V. Phone/Fax

Practice location:
  • Phone: 856-935-4800
  • Fax: 856-935-4900
Mailing address:
  • Phone: 856-935-4800
  • Fax: 856-935-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03355700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20151
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: