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General NPI Number Information
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NPI Number | 1013987940
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Entity Type | Organization
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Legal Business Name | RESES PHARMACY LLC
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Dates
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Enumeration Date | 01/24/2006
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 269 W WHITE HORSE PIKE
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City | POMONA
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State | NJ
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Zip | 08240
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Country | US
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Telephone | 609-965-3600
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Fax | 609-965-4330
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Provider Business Mailing Address
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Address Line | 269 W WHITE HORSE PIKE P O BOX 889
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City | POMONA
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State | NJ
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Zip | 08240
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Country | US
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Telephone | 609-965-3600
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Fax | 609-965-4330
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Authorized Official
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Title or Position | PIC (OWNER)
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Name | KAMLESH VAVAIYA
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Credential | R.PH
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Telephone | 609-965-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00347500
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License Number State | NJ
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