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Organization
CENTRAL AVE PHARMACY LLC
Active
Organization
CENTRAL AVE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELMOATAZBELLAH A TAMMAA (PHARMACIST IN CHARGE)
(631) 572-7973
Entity
Organization
Contact information
Practice address
355 CENTRAL AVE # 363, EAST ORANGE, NJ 07018
(973) 666-5363
Mailing address
355 CENTRAL AVE # 363, EAST ORANGE, NJ 07018
(973) 666-5363
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RS00785200
NJ STATE BOARD OF PHARMACY
NJ
Enumeration date
08/27/2021
Last updated
05/06/2022
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