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Organization
MIL-DAN, INC
Active
Organization
MIL-DAN, INC
Active
Other names
Westside Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MILES K ETTMAN RPH (PHARMACIST-IN-CHARGE)
(609) 394-0600
Entity
Organization
Contact information
Practice address
215 N HERMITAGE AVE, TRENTON, NJ 08618-5511
(609) 394-0600
(609) 394-5505
Mailing address
215 N HERMITAGE AVE, TRENTON, NJ 08618-5511
(609) 394-0600
(609) 394-5505
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0125164
NJ
3336C0003X
Community/Retail Pharmacy
Primary
28RS00378900
NJ
Other
Enumeration date
06/16/2006
Last updated
11/08/2008
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