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General NPI Number Information
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NPI Number | 1518079516
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Entity Type | Organization
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Legal Business Name | MORRISTOWN PHARMACY LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 09/08/2017
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Provider Practice Location Address
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Address Line | 76 MORRIS ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-4182
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Country | US
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Telephone | 973-538-5053
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Fax | 973-538-5281
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Provider Business Mailing Address
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Address Line | 76 MORRIS ST
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City | MORRISTOWN
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State | NJ
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Zip | 07960-4182
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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 | PRESIDENT
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Name | RAJU V PENEMATCHA
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Credential |
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Telephone | 732-619-3164
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00642100
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License Number State | NJ
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