# ST MARIA PHARMACY

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

## Provider details

- **NPI number:** 1972038446
- **Authorized official:** RANDA WISA RPH (PHARMACIST IN CHARGE)
- **Authorized official phone:** (732) 485-9570

## Contact information

- **Practice address:** 1004 COMMONS DR, EAST BRUNSWICK, NJ 08816-5217
- **Practice address phone:** (732) 485-9570
- **Mailing address:** 1004 COMMONS DR, EAST BRUNSWICK, NJ 08816-5217
- **Mailing address phone:** (732) 485-9570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 28RI03792000 | NJ | Yes |

## Other

- **Enumeration date:** 04/21/2017
- **Last updated:** 04/21/2017