MEDICARE: DRUG FAIR GROUP, 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	5534	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1639154255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRUG FAIR GROUP, INC.

Provider Business Mailing Address
First Line	:	800 COTTONTAIL LN
Second Line	:
City	:	SOMERSET
State	:	NJ
Zip	:	08873-1227
Country	:	US
Telephone Number	:	732-748-8900
Fax Number	:	732-868-4172

Provider Business Practice Location Address
First Line	:	1303 N BROAD ST
Second Line	:
City	:	HILLSIDE
State	:	NJ
Zip	:	07205-2404
Country	:	US
Telephone Number	:	908-436-2100
Fax Number	:	908-436-2108

Authorized Official
Title or Position	:	V.P. PHARMACY
Name	:	MR. BARRIE LEVINE
Credential	:	R.PH.
Telephone Number	:	732-748-8900

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	03/28/2008

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