Organization
FIVE TOWNS PHARMACY LLC
Active
Other names
Invictus Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEYER DAVIDOFF PHARMD, RPH (CEO)
(201) 880-7000
Entity
Organization
Contact information
Practice address
60 ESSEX ST STE 105, ROCHELLE PARK, NJ 07662-4347
(201) 880-7000
(201) 880-7094
Mailing address
60 ESSEX ST STE 105, ROCHELLE PARK, NJ 07662-4347
(201) 880-7000
(201) 880-7094
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00759500
NJ
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036775
PHARMACY LICENSE
NY
05
—
0605867
—
NJ
01
—
2173100
PK
—
Enumeration date
10/18/2017
Last updated
10/19/2020
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