# MAPLE SHADE APOTHECARY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942023965
- **Authorized official:** MUHAMMAD REHAN KHAN (OWNER)
- **Authorized official phone:** (856) 779-8300

## Contact information

- **Practice address:** 25 W MAIN ST, MAPLE SHADE, NJ 08052-2411
- **Practice address phone:** (856) 779-8300
- **Mailing address:** 25 W MAIN ST, MAPLE SHADE, NJ 08052-2411
- **Mailing address phone:** (856) 779-8300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/07/2024
- **Last updated:** 11/07/2024