MEDICARE: GEORGE BLUMETTI 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	28RI01573600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28RI01573600	OTHER	NJ	PHARMACY LICENSE

General Provider Information

NPI Number	:	1871873414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE BLUMETTI RPH

Provider Business Mailing Address
First Line	:	41 KNOB HILL RD
Second Line	:
City	:	MORGANVILLE
State	:	NJ
Zip	:	07751-9512
Country	:	US
Telephone Number	:	732-591-0859
Fax Number	:

Provider Business Practice Location Address
First Line	:	2995 HIGHWAY 35
Second Line	:
City	:	HAZLET
State	:	NJ
Zip	:	07730-1526
Country	:	US
Telephone Number	:	732-497-9600
Fax Number	:	732-497-9107

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

Provider Enumeration Date	:	08/26/2011
Last Update Date	:	08/26/2011

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Directions to “ GEORGE BLUMETTI RPH” Practice Location

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