Organization
WELL MART & PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEONG IN PARK (PIC, OWNER)
(201) 482-4705
Entity
Organization
Contact information
Practice address
2182 LEMOINE AVE, FORT LEE, NJ 07024-6009
(201) 482-4705
(201) 482-4905
Mailing address
2182 LEMOINE AVE, FORT LEE, NJ 07024-6009
(201) 482-4705
(201) 482-4905
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RS00781700
NJ PHARMACY LICENSE NUMBER
NJ
Enumeration date
12/09/2020
Last updated
12/09/2020
Update your record
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