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General NPI Number Information
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NPI Number | 1457758633
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Entity Type | Organization
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Legal Business Name | SPECIALTY RX
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 209 E 11TH AVE
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City | ROSELLE
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State | NJ
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Zip | 07203-2015
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Country | US
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Telephone | 908-241-6337
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Fax | 908-634-4022
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Provider Business Mailing Address
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Address Line | 209 E 11TH AVE
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City | ROSELLE
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State | NJ
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Zip | 07203-2015
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Country | US
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Telephone | 908-241-6337
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Fax | 908-634-4022
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Authorized Official
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Title or Position | COLLECTIONS
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Name | MR. JOE O
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Credential |
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Telephone | 908-241-6337
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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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