Organization
SUPER DRUGS LLC
Active
Other names
My Wallington Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHIRAG PATEL (OWNER/MANAGER)
(862) 215-5208
Entity
Organization
Contact information
Practice address
25 LOCUST AVE, WALLINGTON, NJ 07057-1304
(973) 777-4717
(973) 777-4719
Mailing address
25 LOCUST AVE, WALLINGTON, NJ 07057-1304
(973) 777-4717
(973) 777-4719
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00739500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0499048
—
NJ
01
—
2151205
PK
—
Enumeration date
04/01/2015
Last updated
03/17/2017
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