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General NPI Number Information
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NPI Number | 1760994693
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Entity Type | Organization
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Legal Business Name | REFUAH RX LLC
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 911 E COUNTY LINE RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2069
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Country | US
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Telephone | 732-942-9987
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Fax | 732-328-2222
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Provider Business Mailing Address
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Address Line | 911 E COUNTY LINE RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2069
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Country | US
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Telephone | 732-942-9987
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Fax | 732-328-2222
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. RACHEL BRACH
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Credential |
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Telephone | 732-942-9987
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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 | 28RI01577200
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License Number State | NJ
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