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General NPI Number Information
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NPI Number | 1275998890
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Entity Type | Organization
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Legal Business Name | KENNEDY PHARMACY
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Dates
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Enumeration Date | 12/26/2015
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Last Update Date | 03/25/2018
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Provider Practice Location Address
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Address Line | 1 LINCOLN HWY STORE # 3
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City | EDISON
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State | NJ
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Zip | 08820-3962
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Country | US
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Telephone | 732-515-9500
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Fax | 732-515-9503
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Provider Business Mailing Address
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Address Line | 1 LINCOLN HWY STORE # 3
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City | EDISON
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State | NJ
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Zip | 08820-3962
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Country | US
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Telephone | 732-515-9500
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Fax | 732-515-9503
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | HEMANT H VORA
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Credential | R.PH.
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Telephone | 732-515-9500
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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 | APPLICATION IN PROCE
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License Number State |
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