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General NPI Number Information
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NPI Number | 1730487125
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Entity Type | Organization
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Legal Business Name | LITTLE FALLS MEDCARE
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 75 NEWARK POMPTON TPKE
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City | LITTLE FALLS
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State | NJ
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Zip | 07424-1107
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Country | US
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Telephone | 973-638-1561
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Fax | 973-638-1566
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Provider Business Mailing Address
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Address Line | 75 NEWARK POMPTON TPKE
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City | LITTLE FALLS
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State | NJ
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Zip | 07424-1107
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Country | US
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Telephone | 973-638-1561
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Fax | 973-638-1566
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Authorized Official
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Title or Position | R.PH. IN CHARGE
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Name | MR. VINCENZO POLISE
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Credential | R.PH.
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Telephone | 702-561-5628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RS00711000
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License Number State | NJ
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