Organization
MARLBORO VILLAGE PHARMACY INC
Active
Other names
Marlboro Village Pharmacy, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
STANSISLAV HISH (PHARMACIST IN CHARGE)
(732) 617-6060
Entity
Organization
Contact information
Practice address
12 SCHOOL RD W, MARLBORO, NJ 07746-1507
(732) 617-6060
(732) 719-2323
Mailing address
12 SCHOOL RD W, MARLBORO, NJ 07746-1507
(732) 617-6060
(732) 719-2323
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00726200
NJ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406864
—
NJ
01
—
2136249
PK
—
Enumeration date
07/27/2012
Last updated
12/30/2020
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