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Organization
PASSAIC COMMUNITY PHARMACY INC
Active
Organization
PASSAIC COMMUNITY PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM AWAD (OFFICER)
(973) 471-0160
Entity
Organization
Contact information
Practice address
339 PASSAIC STREET, PASSAIC, NJ 07055
(973) 471-0160
(973) 471-0110
Mailing address
9 CHRISTOPHER COURT, MATAWAN, NJ 07747
(973) 471-0160
(973) 471-0110
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RS00592100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99984
AMERIROUP ID #
NJ
Enumeration date
06/17/2006
Last updated
08/22/2020
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