# 15W PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 15W Pharmacy Edison
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740285071
- **Authorized official:** DONNA M MCCANN (REIMBURSEMENT DIRECTOR)
- **Authorized official phone:** (732) 346-1333

## Contact information

- **Practice address:** 95 NEWFIELD AVE, STE B, EDISON, NJ 08837-3824
- **Practice address phone:** (732) 346-1333
- **Practice address fax:** (732) 346-9221
- **Mailing address:** 95 NEWFIELD AVE, STE B, EDISON, NJ 08837-3824
- **Mailing address phone:** (732) 346-1333
- **Mailing address fax:** (732) 346-9221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 28RS00607000 | NJ | Yes |

## Other

- **Enumeration date:** 06/14/2005
- **Last updated:** 07/13/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0019646380001 | — | PA |
| 05 | — | 02282268 | — | NY |
| 01 | — | 3144209 | NCPDP | NJ |
| 05 | — | 8710309 | — | NJ |
| 05 | — | 8710317 | — | NJ |