Organization
MYSTIC PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL WARD RP (PHARMACIST IN CHARGE)
(609) 296-0934
Entity
Organization
Contact information
Practice address
972 RADIO RD, LITTLE EGG HARBOR, NJ 08087
(609) 296-0934
(609) 296-6250
Mailing address
972 RADIO RD, LITTLE EGG HARBOR, NJ 08087
(609) 296-0934
(609) 296-6250
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28RS00391800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4337905
—
NJ
Enumeration date
02/01/2007
Last updated
08/22/2020
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