=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235181785
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRUG FAIR GROUP, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2006
-----------------------------------------------------
Last Update Date | 02/03/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2960 ROUTE 10 WEST
-----------------------------------------------------
City | MORRIS PLAINS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07950
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-984-3417
-----------------------------------------------------
Fax | 973-993-5803
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 COTTONTAIL LN
-----------------------------------------------------
City | SOMERSET
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08873-1227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-748-8900
-----------------------------------------------------
Fax | 732-868-4172
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | V.P. PHARMACY
-----------------------------------------------------
Name | MR. EDWARD G MCGINLEY
-----------------------------------------------------
Credential | R.PH.
-----------------------------------------------------
Telephone | 732-748-8900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 5833
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------