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Organization
JEA AVA MARIA LLC
Active
Organization
JEA AVA MARIA LLC
Active
Other names
MAIN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GHALY (MANAGING MEMBER)
(973) 334-0519
Entity
Organization
Contact information
Practice address
203 MAIN ST, BOONTON, NJ 07005-1749
(973) 334-0519
(973) 334-9390
Mailing address
203 MAIN ST, BOONTON, NJ 07005-1749
(973) 334-0519
(973) 334-9390
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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