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General NPI Number Information
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NPI Number | 1417264417
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Entity Type | Organization
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Legal Business Name | HOLIDAY CITY PHARMACY, LLC
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Dates
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Enumeration Date | 09/12/2010
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Last Update Date | 04/15/2011
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Provider Practice Location Address
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Address Line | 833 ROUTE 37 W
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City | TOMS RIVER
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State | NJ
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Zip | 08755-5038
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Country | US
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Telephone | 732-349-3999
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Fax | 732-349-3900
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Provider Business Mailing Address
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Address Line | 833 ROUTE 37 W
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City | TOMS RIVER
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State | NJ
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Zip | 08755-5038
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Country | US
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Telephone | 732-349-3999
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Fax | 732-349-3900
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Authorized Official
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Title or Position | MEMBER
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Name | MR. NAVEEN PARUPALLI
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Credential |
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Telephone | 732-349-3999
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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 | 28RS00708200
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License Number State | NJ
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