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General NPI Number Information
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NPI Number | 1891247474
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Entity Type | Organization
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Legal Business Name | QUICKCHEK PHARMACY
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 260-280 BROADWAY
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City | BAYONNE
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State | NJ
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Zip | 07002-7501
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Country | US
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Telephone | 201-437-2193
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Fax |
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Provider Business Mailing Address
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Address Line | 210 LYNN LN
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City | WESTFIELD
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State | NJ
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Zip | 07090-1811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. ANGELO GIANNETTA
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Credential | RPH
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Telephone | 201-437-2193
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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 | 28RI02412900
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License Number State | NJ
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