MEDICARE: GUS PHARMACY, LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1891546834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUS PHARMACY, LLC

Provider Business Mailing Address
First Line	:	42 E LAUREL RD STE 1900
Second Line	:
City	:	STRATFORD
State	:	NJ
Zip	:	08084-1336
Country	:	US
Telephone Number	:	856-346-3535
Fax Number	:	856-346-4953

Provider Business Practice Location Address
First Line	:	42 E LAUREL RD STE 1900
Second Line	:
City	:	STRATFORD
State	:	NJ
Zip	:	08084-1336
Country	:	US
Telephone Number	:	856-346-3535
Fax Number	:	856-346-4953

Authorized Official
Title or Position	:	OWNER/RPIC
Name	:	KONSTANTINOS N TZAFEROS
Credential	:	PHARMD
Telephone Number	:	856-346-3535

Provider Enumeration Date	:	03/28/2024
Last Update Date	:	03/28/2024

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Directions to “GUS PHARMACY, LLC ” Practice Location

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