MEDICARE: MR. EUGENE RAYMOND TOMPKINS RPH

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	183500000X	Pharmacist	28RI01524400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28RIO524400	OTHER	NJ	PHARMACY LICENSE

General Provider Information

NPI Number	:	1669641924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EUGENE RAYMOND TOMPKINS RPH

Provider Business Mailing Address
First Line	:	1730 US HIGHWAY 46
Second Line	:
City	:	WEST PATERSON
State	:	NJ
Zip	:	07424-1716
Country	:	US
Telephone Number	:	973-812-3434
Fax Number	:	973-812-9433

Provider Business Practice Location Address
First Line	:	1730 US HIGHWAY 46
Second Line	:
City	:	WEST PATERSON
State	:	NJ
Zip	:	07424-1716
Country	:	US
Telephone Number	:	973-812-3434
Fax Number	:	973-812-9433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	02/20/2008

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Directions to “ MR. EUGENE RAYMOND TOMPKINS RPH” Practice Location

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