Healthcare Provider Details

I. General information

NPI: 1740104462
Provider Name (Legal Business Name): EXPRESS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 SICKLERVILLE RD UNIT C1
SICKLERVILLE NJ
08081-2556
US

IV. Provider business mailing address

416 SICKLERVILLE RD UNIT C1
SICKLERVILLE NJ
08081-2556
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-1100
  • Fax:
Mailing address:
  • Phone: 856-566-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SIDRA TAHER
Title or Position: MANAGING MEMBER
Credential:
Phone: 856-566-1100