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General NPI Number Information
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NPI Number | 1639003346
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Entity Type | Organization
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Legal Business Name | FAIRFIELD PHARMACY RX LLC
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 435 HOLLYWOOD AVE STE 4
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City | FAIRFIELD
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State | NJ
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Zip | 07004-2406
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Country | US
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Telephone | 862-213-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 43 LINDEN AVE
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City | LINCOLN PARK
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State | NJ
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Zip | 07035-2545
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Country | US
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Telephone | 862-213-2061
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHATHA KHALIL
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Credential |
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Telephone | 862-213-2061
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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 |
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License Number State |
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