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General NPI Number Information
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NPI Number | 1609167493
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Entity Type | Organization
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Legal Business Name | TOWN & COUNTRY COMPOUNDING AND CONSULTATION LLC, SERIES T&C NEUROMAX
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 535 E CRESCENT AVE
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City | RAMSEY
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State | NJ
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Zip | 07446-2922
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Country | US
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Telephone | 484-410-3171
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Fax | 866-587-8915
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Provider Business Mailing Address
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Address Line | 535 E CRESCENT AVE
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City | RAMSEY
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State | NJ
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Zip | 07446-2922
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Country | US
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Telephone | 201-447-2020
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | KIMBERLY ANN HANSEN
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Credential |
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Telephone | 201-447-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 28RS00624100
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License Number State | NJ
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