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Organization
FAIRVIEW PHARMACY LLC
Active
Organization
FAIRVIEW PHARMACY LLC
Active
Other names
Fairview Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT MONTFORT RPH (PIC, AO)
(201) 840-8049
Entity
Organization
Contact information
Practice address
151 ANDERSON AVE, FAIRVIEW, NJ 07022-1754
(201) 840-8049
(201) 945-0816
Mailing address
151 ANDERSON AVE, FAIRVIEW, NJ 07022-1754
(201) 840-8049
(201) 945-0816
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
28RS00736100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148289
PK
—
Enumeration date
10/01/2014
Last updated
02/16/2017
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