Organization
MPS RX TRI-STATE LLC
Active
Other names
Millennium Pharmacy Systems Inc S
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI DELANY RPH (MANAGER, BUSINESS SYSTEMS SUPPORT)
(201) 784-1643
Entity
Organization
Contact information
Practice address
22 PARIS AVE, NORTHVALE, NJ 07647-2600
(201) 784-1643
Mailing address
22 PARIS AVE, NORTHVALE, NJ 07647-2600
(201) 784-1643
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
28RS00701000
NJ
333600000X
Pharmacy
28RS00701000
NJ
3336L0003X
Long Term Care Pharmacy
Primary
28RS00701000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE & MEDICAID PENDING
—
Enumeration date
02/25/2010
Last updated
03/02/2010
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