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General NPI Number Information
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NPI Number | 1467719005
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Entity Type | Organization
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Legal Business Name | PCA-LTC PHARMACY
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 05/11/2012
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Provider Practice Location Address
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Address Line | 66 FORD RD STE 220
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City | DENVILLE
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State | NJ
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Zip | 07834-1300
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Country | US
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Telephone | 973-453-4666
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Fax | 973-983-5684
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Provider Business Mailing Address
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Address Line | 66 FORD RD SUITE 220
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City | DENVILLE
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State | NJ
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Zip | 07834-1379
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Country | US
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Telephone | 973-453-4666
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Fax | 973-983-5684
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY SEKULSKI
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Credential |
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Telephone | 973-453-4666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 28RS00718400
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License Number State | NJ
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