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NPI Code Detail

MEDICARE: TONYS PHARMACY INC.

MEDICARE: TONYS PHARMACY INC.
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
1332B00000XDurable Medical Equipment & Medical Supplies28RS00566500NJ
23336C0004XCompounding Pharmacy28RS00566500NJ
3333600000XPharmacy28RS00566500NJ
43336C0003XCommunity/Retail Pharmacy28RS00566500NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538144787
Entity Type Code : Organization
Provider Name (Legal Business Name) : TONYS PHARMACY INC.
Provider Business Mailing Address
First Line : 534 21ST AVE
Second Line :
City : PATERSON
State : NJ
Zip : 07513-1337
Country : US
Telephone Number : 973-742-6655
Fax Number : 973-742-7741
Provider Business Practice Location Address
First Line : 534 21ST AVE
Second Line :
City : PATERSON
State : NJ
Zip : 07513-1337
Country : US
Telephone Number : 973-742-6655
Fax Number : 973-742-7741
Authorized Official
Title or Position : PRESIDENT
Name : MR. ANTONIO ORESTES RODRIGUEZ
Credential :
Telephone Number : 973-742-6655
Provider Enumeration Date : 12/09/2005
Last Update Date : 01/25/2010

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Directions to “TONYS PHARMACY INC. ” Practice Location

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