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General NPI Number Information
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NPI Number | 1386903433
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Entity Type | Organization
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Legal Business Name | PHARMEDIUM SERVICES, LLC
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 43 DISTRIBUTION BLVD
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City | EDISON
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State | NJ
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Zip | 08817-6005
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Country | US
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Telephone | 732-287-8655
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Fax |
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Provider Business Mailing Address
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Address Line | 43 DISTRIBUTION BLVD
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City | EDISON
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State | NJ
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Zip | 08817-6005
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Country | US
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Telephone | 732-287-8655
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RICHARD J. KRUZYNSKI
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Credential | RPH
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Telephone | 847-457-2302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 28RS00632500
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License Number State | NJ
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