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General NPI Number Information
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NPI Number | 1588941371
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Entity Type | Organization
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Legal Business Name | ORPHAN DRUG PROFESSIONAL SERVICES LLC
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 495 N 13TH ST
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City | NEWARK
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State | NJ
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Zip | 07107-1317
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Country | US
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Telephone | 973-587-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 495 N 13TH ST
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City | NEWARK
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State | NJ
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Zip | 07107-1317
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Country | US
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Telephone | 973-587-7707
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | RICHARD BURGUILLOS
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Credential |
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Telephone | 973-587-7707
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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 | 28RS00715900
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License Number State | NJ
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