Organization
SAINT MARY AND JESSIE LLC
Active
Other names
ADVANCED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ASHRAF DAWOD (OWNER)
(732) 324-4490
Entity
Organization
Contact information
Practice address
288 SMITH ST, PERTH AMBOY, NJ 08861-4042
(732) 324-4490
(732) 324-4491
Mailing address
288 SMITH ST, PERTH AMBOY, NJ 08861-4042
(732) 324-4490
(732) 324-4491
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00645500
NJ
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061999
—
NJ
01
—
2055524
PK
—
Enumeration date
07/30/2006
Last updated
07/28/2016
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