# THE ESTAUGH

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

## Provider details

- **NPI number:** 1740226836
- **Authorized official:** FRANK SIMMONS PHARM D (PHCY DIR)
- **Authorized official phone:** (609) 654-3391

## Contact information

- **Practice address:** 1 MEDFORD LEAS, MEDFORD, NJ 08055-2254
- **Practice address phone:** (609) 654-3269
- **Practice address fax:** (609) 257-0827
- **Mailing address:** 1 MEDFORD LEAS, MEDFORD, NJ 08055-2254
- **Mailing address phone:** (609) 654-3269
- **Mailing address fax:** (609) 257-0827

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00192000 | NJ | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |
| 3336M0003X | Managed Care Organization Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/20/2006
- **Last updated:** 07/20/2016