# MIL-DAN, INC

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

## Provider details

- **NPI number:** 1679517049
- **Authorized official:** MR. MILES K ETTMAN RPH (PHARMACIST-IN-CHARGE)
- **Authorized official phone:** (609) 394-0600

## Contact information

- **Practice address:** 215 N HERMITAGE AVE, TRENTON, NJ 08618-5511
- **Practice address phone:** (609) 394-0600
- **Practice address fax:** (609) 394-5505
- **Mailing address:** 215 N HERMITAGE AVE, TRENTON, NJ 08618-5511
- **Mailing address phone:** (609) 394-0600
- **Mailing address fax:** (609) 394-5505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0125164 | NJ | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00378900 | NJ | Yes |

## Other

- **Enumeration date:** 06/16/2006
- **Last updated:** 11/08/2008