# PASSAIC PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TONYS PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679558597
- **Authorized official:** MR. ANTONIO ORESTES RODRIGUEZ (PRESIDENT)
- **Authorized official phone:** (973) 777-3121

## Contact information

- **Practice address:** 291 MONROE ST, PASSAIC, NJ 07055-5209
- **Practice address phone:** (973) 777-3121
- **Practice address fax:** (973) 777-3181
- **Mailing address:** 291 MONROE ST, PASSAIC, NJ 07055-5209
- **Mailing address phone:** (973) 777-3121
- **Mailing address fax:** (973) 777-3181

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 28RS00414400 | NJ | — |
| 333600000X | Pharmacy | 28RS00414400 | NJ | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00414400 | NJ | Yes |
| 3336C0004X | Compounding Pharmacy | 28RS00414400 | NJ | — |

## Other

- **Enumeration date:** 12/14/2005
- **Last updated:** 02/01/2010