Organization
VITAL PLUS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA TAN (AO)
(862) 267-0385
Entity
Organization
Contact information
Practice address
10 W BROADWAY, PATERSON, NJ 07505-1032
(862) 267-0385
Mailing address
10 W BROADWAY, PATERSON, NJ 07505-1032
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00753500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0558851
—
NJ
Enumeration date
12/14/2016
Last updated
05/25/2017
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