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General NPI Number Information
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NPI Number | 1053285676
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Entity Type | Organization
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Legal Business Name | MAPLEWOOD VILLAGE PHARMACY LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 101 BAKER ST UNIT B
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2782
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Country | US
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Telephone | 732-234-0050
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Fax | 732-234-0049
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Provider Business Mailing Address
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Address Line | 101 BAKER ST UNIT B
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-2782
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Country | US
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Telephone | 732-234-0050
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Fax | 732-234-0049
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Authorized Official
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Title or Position | MANAGER
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Name | MINA GIRGIS
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Credential |
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Telephone | 201-515-7676
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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 |
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License Number State |
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