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General NPI Number Information
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NPI Number | 1568521565
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Entity Type | Organization
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Legal Business Name | COLTS NECK FAMILY DRUGS INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/21/2010
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Provider Practice Location Address
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Address Line | 293 RT 34 SUITE 201
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City | COLTS NECK
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State | NJ
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Zip | 07722
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Country | US
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Telephone | 732-677-3380
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Fax | 732-677-3382
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Provider Business Mailing Address
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Address Line | 11 EQUINOX LN
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City | FREEHOLD
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State | NJ
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Zip | 07728-8652
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Country | US
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Telephone | 732-252-5615
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH MASTROKOSTAS
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Credential |
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Telephone | 732-677-3380
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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 | 28RS00666300
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License Number State | NJ
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