Organization
PETER PAN PHARMACY INC
Active
Other names
PETER PAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KORNAS (OWNER)
(908) 754-7607
Entity
Organization
Contact information
Practice address
2125 PARK AVE, S PLAINFIELD, NJ 07080-5401
(908) 754-7607
(908) 754-9106
Mailing address
2125 PARK AVE, S PLAINFIELD, NJ 07080-5401
(908) 754-7607
(908) 754-9106
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00323500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2056494
PK
—
05
—
4253906
—
NJ
Enumeration date
02/01/2007
Last updated
08/10/2016
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