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General NPI Number Information
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NPI Number | 1538492350
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Entity Type | Organization
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Legal Business Name | ROSELLE CENTER RITA PHARMACY
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 09/11/2009
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Provider Practice Location Address
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Address Line | 570 RARITAN RD
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City | ROSELLE
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State | NJ
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Zip | 07203-2446
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Country | US
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Telephone | 908-245-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CHESTNUT ST P.O.BOX 167
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City | ROSELLE PARK
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State | NJ
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Zip | 07204-2263
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Country | US
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Telephone | 732-668-2835
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. MALAV D KANUGA
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Credential | M.PHARM
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Telephone | 732-668-2835
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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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