Organization
MADISON RX, INC
Active
Other names
Bottle Hill Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NARENDRA B VUTLA RPH (PRESIDENT)
(973) 377-0009
Entity
Organization
Contact information
Practice address
42 MAIN ST, MADISON, NJ 07940-1895
(973) 377-0009
(973) 301-0300
Mailing address
42 MAIN STREET, MADISON, NJ 07940
(973) 377-0009
(973) 301-0300
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00686500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7727607
—
NJ
01
—
7727615
MEDICAID DME
NJ
Enumeration date
12/19/2006
Last updated
06/12/2009
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