Organization
LAKEWOOD PHARMACY LLC
Active
Other names
REFUA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAYA ITZHAKOV (PRESIDENT)
(718) 454-3052
Entity
Organization
Contact information
Practice address
911 E COUNTY LINE RD, LAKEWOOD, NJ 08701-2069
(732) 942-9987
(732) 810-0260
Mailing address
911 E COUNTY LINE RD, LAKEWOOD, NJ 08701-2069
(732) 942-9987
(732) 810-0260
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00605700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8747709
—
NJ
05
—
8747717
—
NJ
Enumeration date
08/15/2006
Last updated
05/10/2010
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