=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699641530
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH BRUNSWICK PHARMACY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2025
-----------------------------------------------------
Last Update Date | 10/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1825 ROUTE 130 STE 3
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902-3087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-940-9940
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1825 ROUTE 130 STE 3
-----------------------------------------------------
City | NORTH BRUNSWICK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08902-3087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-940-9940
-----------------------------------------------------
Fax | 732-940-9930
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST-IN-CHARGE
-----------------------------------------------------
Name | DR. MARC A GABALLA
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 732-556-7009
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------