Healthcare Provider Details

I. General information

NPI: 1689771511
Provider Name (Legal Business Name): STEVEN DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 MONMOUTH RD
W LONG BRANCH NJ
07764-1150
US

IV. Provider business mailing address

349 MONMOUTH RD
W LONG BRANCH NJ
07764-1150
US

V. Phone/Fax

Practice location:
  • Phone: 732-222-4411
  • Fax: 732-222-5025
Mailing address:
  • Phone: 732-222-4411
  • Fax: 732-222-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00226200
License Number StateNJ

VIII. Authorized Official

Name: DAVID FISHER
Title or Position: MANAGER
Credential: RPH
Phone: 732-222-4411