# SOUTH ORANGE PHARMACY LLC

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

## Provider details

- **NPI number:** 1861643561
- **Authorized official:** CHRISTOPHER OTTO (OWNER)
- **Authorized official phone:** (973) 821-5414

## Contact information

- **Practice address:** 73 S ORANGE AVE, SOUTH ORANGE, NJ 07079-1715
- **Practice address phone:** (973) 821-5414
- **Practice address fax:** (973) 275-5220
- **Mailing address:** 73 S ORANGE AVE, SOUTH ORANGE, NJ 07079-1715
- **Mailing address phone:** (973) 821-5414
- **Mailing address fax:** (973) 275-5220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00687000 | NJ | Yes |

## Other

- **Enumeration date:** 10/01/2008
- **Last updated:** 12/20/2016