MEDICARE: LANDMARK DRUG CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	28RS00612300	NJ
2	332B00000X	Durable Medical Equipment & Medical Supplies	RSRS00612300	NJ
3	3336C0003X	Community/Retail Pharmacy	28RS00612300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	3112959	OTHER	NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528134301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANDMARK DRUG CORP

Provider Business Mailing Address
First Line	:	345 SOMERSET ST
Second Line	:
City	:	NORTH PLAINFIELD
State	:	NJ
Zip	:	07060-4774
Country	:	US
Telephone Number	:	908-412-9400
Fax Number	:	908-757-2228

Provider Business Practice Location Address
First Line	:	345 SOMERSET ST
Second Line	:
City	:	NORTH PLAINFIELD
State	:	NJ
Zip	:	07060-4774
Country	:	US
Telephone Number	:	908-412-9400
Fax Number	:	908-757-2228

Authorized Official
Title or Position	:	PHARMACIST IN-CHARGE & DIRECTOR
Name	:	MR. ANKAMMA ATTOTI
Credential	:	MS (PHARMACY) & R.PH
Telephone Number	:	908-412-9400

Provider Enumeration Date	:	11/25/2006
Last Update Date	:	03/06/2008

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Directions to “LANDMARK DRUG CORP ” Practice Location

Language	Start Address	Practice Location

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