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General NPI Number Information
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NPI Number | 1619417128
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Entity Type | Organization
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Legal Business Name | D&M VENTURES LLC
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 101 PROSPECT ST SUITE#115
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5020
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Country | US
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Telephone | 848-245-0997
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Fax | 848-245-0998
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Provider Business Mailing Address
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Address Line | 101 PROSPECT ST SUITE#115
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5020
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Country | US
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Telephone | 848-245-0997
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Fax | 848-245-0998
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | TUSHAR PATEL
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Credential |
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Telephone | 848-245-0997
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00754900
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License Number State | NJ
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