Healthcare Provider Details

I. General information

NPI: 1982102117
Provider Name (Legal Business Name): APOTHECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 05/13/2020
Certification Date: 05/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SHEARER CT
TABERNACLE NJ
08088-9382
US

IV. Provider business mailing address

6 SHEARER CT
TABERNACLE NJ
08088-9382
US

V. Phone/Fax

Practice location:
  • Phone: 609-451-0277
  • Fax:
Mailing address:
  • Phone: 609-451-0277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number28RI03198300
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: AMANDA WILLIAMS
Title or Position: MANAGING PARTNER
Credential: PHARM.D.
Phone: 609-451-0277