Organization
BRUNSWICK SQUARE PHARMACY
Active
Other names
Brunswick Square Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAN MIKAILLE (PRESIDENT)
(201) 726-3033
Entity
Organization
Contact information
Practice address
1177 STATE ROUTE 18, EAST BRUNSWICK, NJ 08816-4935
(732) 257-5200
(732) 257-2600
Mailing address
12 BEVERLY RD, OLD BRIDGE, NJ 08857-1614
(732) 257-5200
(732) 257-2600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00718900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135495
PK
—
Enumeration date
05/10/2012
Last updated
02/14/2017
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