# FANWOOD RX CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fanwood Pharmacy LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225901374
- **Authorized official:** MITUL P PATEL PHARMD (OWNER)
- **Authorized official phone:** (908) 680-6936

## Contact information

- **Practice address:** 45 S MARTINE AVE, FANWOOD, NJ 07023-1216
- **Practice address phone:** (908) 680-6936
- **Practice address fax:** (908) 680-6937
- **Mailing address:** 1 TED LIGHT WAY, PISCATAWAY, NJ 08854-5094
- **Mailing address phone:** (908) 680-6936
- **Mailing address fax:** (908) 680-6937

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/25/2025
- **Last updated:** 09/25/2025