Organization
DELRAN PHARMACY
Active
Other names
Delran Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH JESUELE (OWNER,PIC,AO)
(856) 764-5400
Entity
Organization
Contact information
Practice address
88 HARTFORD ROAD, SUITE A, DELRAN, NJ 08075
(856) 764-5400
(856) 461-1364
Mailing address
88 HARTFORD RD, SUITE A, MOORESTOWN, NJ 08057-3736
(856) 764-5400
(856) 461-1364
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00721400
NJ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0316237
—
NJ
01
—
2136999
PK
—
Enumeration date
09/27/2012
Last updated
02/20/2017
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