# REVERENCE DISCOUNT PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235679846
- **Authorized official:** WIDLYNE RUFFIN (PHARMACIST)
- **Authorized official phone:** (609) 445-4423

## Contact information

- **Practice address:** 912 S MAIN ST, PLEASANTVILLE, NJ 08232-3618
- **Practice address phone:** (609) 445-4423
- **Practice address fax:** (609) 445-4423
- **Mailing address:** 5 MOONLIGHT DR, EGG HARBOR TWP, NJ 08234-4927
- **Mailing address phone:** (609) 904-2540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |
| 3336M0002X | Mail Order Pharmacy | — | NULL | — |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/01/2017
- **Last updated:** 04/05/2017