Organization
CRYSTAL DRUGS INC
Active
Other names
NICKS DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
NARENDAR REDDY YASA (OWNER)
(973) 596-1800
Entity
Organization
Contact information
Practice address
179 MARKET ST, NEWARK, NJ 07102
(973) 596-1800
(973) 596-1849
Mailing address
179 MARKET ST, NEWARK, NJ 07102-3707
(973) 596-1800
(973) 596-1849
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00659600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0103837
—
NJ
01
—
3135414
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/22/2006
Last updated
06/06/2018
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