Organization
DRUG FAIR OF EAST RUTHERFOD
Active
Other names
DRUG FAIR OF EAST RUTHERFORD
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY LABEAU (CEO)
(732) 748-8900
Entity
Organization
Contact information
Practice address
LIBERTY COMMONS 51 ROUTE 17 SOUTH, EAST RUTHERFORD, NJ 07073
(201) 531-9901
(210) 531-9919
Mailing address
LIBERTY COMMONS 51 ROUTE 17 SOUTH, EAST RUTHERFORD, NJ 07073
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00678400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3194999
OTHER ID NUMBER
—
Enumeration date
02/26/2008
Last updated
04/09/2008
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