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General NPI Number Information
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NPI Number | 1609145952
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Entity Type | Organization
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Legal Business Name | JR FRIENDLY PHARMACY LLC
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Dates
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Enumeration Date | 12/15/2011
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Last Update Date | 01/03/2024
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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 | 908-587-0020
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Fax | 908-587-1002
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Provider Business Mailing 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 | 908-587-0020
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Fax | 908-587-1002
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES POTTACKAL GEORGE
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Credential |
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Telephone | 973-985-8432
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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 | 28RS00717800
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License Number State | NJ
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