MEDICARE: GREGORY WILLIAM PAPA 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	28RS00255700	NJ

General Provider Information

NPI Number	:	1902834542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY WILLIAM PAPA RPH

Provider Business Mailing Address
First Line	:	23 BRANTLEY WAY
Second Line	:
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-1126
Country	:	US
Telephone Number	:	856-232-9107
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 LAUREL RD E
Second Line	:	SUITE 1900
City	:	STRATFORD
State	:	NJ
Zip	:	08084-1354
Country	:	US
Telephone Number	:	856-346-3535
Fax Number	:	856-346-4953

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	01/25/2008

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