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General NPI Number Information
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NPI Number | 1780082339
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Entity Type | Organization
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Legal Business Name | LEXANN PHARMACY & WELLNESS CENTER
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 1885 SPRINGFIELD AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3419
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Country | US
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Telephone | 973-763-0010
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Fax | 973-763-0009
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Provider Business Mailing Address
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Address Line | 1885 SPRINGFIELD AVE
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-3419
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Country | US
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Telephone | 973-763-0010
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Fax | 973-763-0009
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDER OWOLABI
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Credential |
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Telephone | 973-678-1700
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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 | 28RS00737500
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License Number State | NJ
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