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General NPI Number Information
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NPI Number | 1861705873
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Entity Type | Organization
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Legal Business Name | MAIN PHARMACY LLC
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 80 S MAIN RD STE 112
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City | VINELAND
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State | NJ
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Zip | 08360-7829
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Country | US
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Telephone | 856-692-6246
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Fax | 856-692-0188
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Provider Business Mailing Address
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Address Line | 80 S MAIN RD STE 112
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City | VINELAND
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State | NJ
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Zip | 08360-7829
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Country | US
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Telephone | 856-692-6246
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Fax | 856-692-0188
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Authorized Official
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Title or Position | OWNER
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Name | LILIAM SPIEKER
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Credential | PHARM D
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Telephone | 856-692-6246
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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 | 28RS00705400
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License Number State | NJ
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