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General NPI Number Information
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NPI Number | 1831608157
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Entity Type | Organization
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Legal Business Name | ALLTOWN PHARMACY
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Dates
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Enumeration Date | 09/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 158 WYCKOFF RD
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City | EATONTOWN
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State | NJ
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Zip | 07724
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Country | US
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Telephone | 732-542-7773
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Fax |
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Provider Business Mailing Address
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Address Line | 158 WYCKOFF RD
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City | EATONTOWN
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State | NJ
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Zip | 07724-1890
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Country | US
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Telephone | 732-542-7773
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNA KEYLIN
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Credential | RPH
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Telephone | 732-542-7773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 28RS00626900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 28RS00626900
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License Number State | NJ
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