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General NPI Number Information
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NPI Number | 1811038896
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Entity Type | Organization
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Legal Business Name | GROSSANO AND WEINERT PHARMACY INC
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Dates
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Enumeration Date | 02/10/2007
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Last Update Date | 03/24/2010
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Provider Practice Location Address
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Address Line | 32 S WASHINGTON AVE
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City | BERGENFIELD
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State | NJ
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Zip | 07621-2325
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Country | US
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Telephone | 201-384-2820
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Fax | 201-384-3093
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Provider Business Mailing Address
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Address Line | 32 S WASHINGTON AVE
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City | BERGENFIELD
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State | NJ
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Zip | 07621-2325
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Country | US
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Telephone | 201-384-2820
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Fax | 201-384-3093
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN VINCENT GROSSANO
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Credential | RPH, PHARMD
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Telephone | 201-384-2820
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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 | 28RS00479400
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License Number State | NJ
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