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General NPI Number Information
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NPI Number | 1528948916
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Entity Type | Organization
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Legal Business Name | CHERRYWOOD PLAZA SUPERMARKET LLC
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1468 BLACKWOOD CLEMENTON RD
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City | CLEMENTON
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State | NJ
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Zip | 08021-5778
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Country | US
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Telephone | 856-627-0088
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Fax | 856-782-0968
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Provider Business Mailing Address
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Address Line | 1230 BLACKWOOD CLEMENTON RD
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City | CLEMENTON
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State | NJ
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Zip | 08021-5632
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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 | CORPORATE CONTROLLER
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Name | STACY AURAND
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Credential |
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Telephone | 856-627-6501
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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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