Organization
IMPRIMISRX NJ, LLC
Active
Other names
ImprimisRx
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW RICHARD BOLL (SECRETARY & CFO)
(858) 704-4040
Entity
Organization
Contact information
Practice address
1705 ROUTE 46 STE 4, LEDGEWOOD, NJ 07852-9720
(844) 446-6979
(855) 405-4669
Mailing address
1000 AVIARA DR STE 220, CARLSBAD, CA 92011-4218
(858) 704-4040
(858) 345-1745
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28RS00593300
NJ
3336C0003X
Community/Retail Pharmacy
28RS00593300
NJ
3336C0004X
Compounding Pharmacy
28RS00593300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3143017
NCPDP
NJ
Enumeration date
02/22/2007
Last updated
06/09/2022
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