Healthcare Provider Details

I. General information

NPI: 1255603460
Provider Name (Legal Business Name): CHRISTINA MARIA SOULE PHARM. D., RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2012
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 US HIGHWAY 206 STE 80
STANHOPE NJ
07874-3128
US

IV. Provider business mailing address

90 US HIGHWAY 206 STE 80
STANHOPE NJ
07874-3128
US

V. Phone/Fax

Practice location:
  • Phone: 973-448-1232
  • Fax: 973-448-2488
Mailing address:
  • Phone: 973-448-1232
  • Fax: 973-448-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02798000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: