Organization
MEDICAL MALL RX INC
Active
Other names
Medical Mall Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PARTHIV SHAH (OWNER)
(732) 244-4747
Entity
Organization
Contact information
Practice address
9 HOSPITAL DR STE B3, TOMS RIVER, NJ 08755-6425
(732) 244-4747
(732) 244-4873
Mailing address
9 HOSPITAL DR STE B3, TOMS RIVER, NJ 08755-6425
(732) 244-4747
(732) 244-4873
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00191200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0482595
—
NJ
01
—
2148314
PK
—
Enumeration date
08/10/2006
Last updated
10/03/2016
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