Organization
LEGACY DRUGSTORE INC
Active
Other names
Legacy Drugstore
Organization subpart
No
Provider details
NPI number
Authorized official
GURDINE SOMA (PHARMACIST, OWNER)
(908) 352-0050
Entity
Organization
Contact information
Practice address
400 S BROAD ST, ELIZABETH, NJ 07202-3502
(908) 352-0050
(908) 352-0075
Mailing address
400 S BROAD ST, ELIZABETH, NJ 07202-3502
(908) 352-0050
(908) 352-0075
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00703600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125679
PK
—
Enumeration date
05/28/2010
Last updated
02/17/2015
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