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General NPI Number Information
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NPI Number | 1316832744
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Entity Type | Organization
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Legal Business Name | MTEPHRAIMPHARMACY LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1552 MOUNT EPHRAIM AVE
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City | CAMDEN
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State | NJ
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Zip | 08104-1662
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Country | US
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Telephone | 856-966-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 1552 MOUNT EPHRAIM AVE
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City | CAMDEN
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State | NJ
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Zip | 08104-1662
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING EMPLOYEE
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Name | DHARA GANDHI
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Credential |
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Telephone | 206-693-6202
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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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