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General NPI Number Information
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NPI Number | 1578382008
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Entity Type | Organization
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Legal Business Name | MAPLE RX LLC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 112 HILLSIDE BLVD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3148
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Country | US
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Telephone | 732-370-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 382 ROUTE 59 STE 276
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City | AIRMONT
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State | NY
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Zip | 10952-3422
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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 | PRESIENT
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Name | MR. MOSES WERZBERGER
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Credential |
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Telephone | 845-371-6464
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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 |
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License Number State |
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