Organization
HASIARD MEO ENTERPRISE INC
Active
Other names
SPRINGFIELD AVE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ANTONIA WALTON RPH (RPH IN CHARGE)
(973) 373-5846
Entity
Organization
Contact information
Practice address
658 SPRINGFIELD AVE, NEWARK, NJ 07103-1011
(973) 373-5846
(973) 373-2877
Mailing address
658 SPRINGFIELD AVE, NEWARK, NJ 07103-1011
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
02944
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3122556
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
4325807
—
NJ
Enumeration date
08/10/2006
Last updated
07/11/2008
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