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General NPI Number Information
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NPI Number | 1942570510
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Entity Type | Organization
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Legal Business Name | LAKEWOOD RESOURCE & REFERRAL CENTER
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 1771 MADISON AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1251
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Country | US
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Telephone | 732-537-8559
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Fax | 732-534-8071
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Provider Business Mailing Address
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Address Line | 1771 MADISON AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1251
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Country | US
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Telephone | 732-537-8559
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Fax | 732-534-8071
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID FRIEDMAN
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Credential |
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Telephone | 732-534-8559
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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 | 28RS00716900
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License Number State | NJ
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