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General NPI Number Information
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NPI Number | 1265987127
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Entity Type | Organization
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Legal Business Name | ROLLIES PHARMACY INC
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Dates
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Enumeration Date | 08/22/2016
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 128 CROSS KEYS RD
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City | BERLIN
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State | NJ
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Zip | 08009-9201
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Country | US
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Telephone | 856-210-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 128 CROSS KEYS RD
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City | BERLIN
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State | NJ
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Zip | 08009-9201
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Country | US
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Telephone | 856-210-1515
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DERRY HOLLAND
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Credential |
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Telephone | 609-267-4969
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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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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 28RS00749900
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License Number State | NJ
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