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Organization

TICETOWN PHARMACY & SURGICAL INC

Active
Other names
The Wellness Center Pharmacy & Surgical
Organization subpart
No

Provider details

NPI number
Authorized official
BHAVINI PATEL PHARM.D. (PRESIDENT)
(732) 679-3555
Entity
Organization

Contact information

Practice address
3117 US HIGHWAY 9, OLD BRIDGE, NJ 08857-2690
(732) 679-3555
(732) 679-6797
Mailing address
3117 US HIGHWAY 9, OLD BRIDGE, NJ 08857-2690
(732) 679-3555
(732) 679-6797

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
28RS00700600
NJ
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
12392
NC
3336C0004X
Compounding Pharmacy
034759
NY
3336L0003X
Long Term Care Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0231169
NJ
01
2121584
PK
Enumeration date
08/18/2009
Last updated
07/19/2018
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