Healthcare Provider Details

I. General information

NPI: 1467437046
Provider Name (Legal Business Name): DRUG FAIR GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 11/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 LOCUST AVE
WEST LONG BRANCH NJ
07764-1102
US

IV. Provider business mailing address

800 COTTONTAIL LN
SOMERSET NJ
08873-1227
US

V. Phone/Fax

Practice location:
  • Phone: 732-222-4040
  • Fax: 732-222-0709
Mailing address:
  • Phone: 732-748-8900
  • Fax: 732-868-4172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5080
License Number StateNJ

VIII. Authorized Official

Name: MR. BARRIE LEVINE
Title or Position: V.P. PHARMACY
Credential: R.PH.
Phone: 732-748-8900