Individual
LAWRENCE STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S., R.PH.
Contact information
Practice address
25 PROVIDENT CT, OCEAN, NJ 07712-7266
(732) 915-2999
(732) 230-6615
Mailing address
25 PROVIDENT CT, OCEAN, NJ 07712-7266
(732) 915-2999
(732) 230-6615
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10576
MD
183500000X
Pharmacist
Primary
28RI01888200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10576
MARYLAND BOARD OF PHARMACY
MD
01
—
28RI01888200
NJ BOARD OF PHARMACY
NJ
Enumeration date
01/31/2019
Last updated
01/31/2019
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