# MARLBORO VILLAGE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Marlboro Village Pharmacy, Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003162041
- **Authorized official:** STANSISLAV HISH (PHARMACIST IN CHARGE)
- **Authorized official phone:** (732) 617-6060

## Contact information

- **Practice address:** 12 SCHOOL RD W, MARLBORO, NJ 07746-1507
- **Practice address phone:** (732) 617-6060
- **Practice address fax:** (732) 719-2323
- **Mailing address:** 12 SCHOOL RD W, MARLBORO, NJ 07746-1507
- **Mailing address phone:** (732) 617-6060
- **Mailing address fax:** (732) 719-2323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00726200 | NJ | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/27/2012
- **Last updated:** 12/30/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0406864 | — | NJ |
| 01 | — | 2136249 | PK | — |