Organization
OBENG PHARMACY LLC
Active
Other names
Obeng Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ADJE KOFFI (CEO)
(862) 237-7601
Entity
Organization
Contact information
Practice address
671 MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-1186
(862) 237-7601
(862) 237-7603
Mailing address
671 MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-1186
(862) 237-7601
(862) 237-7603
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00737900
NJ
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149434
PK
—
Enumeration date
01/06/2015
Last updated
01/04/2016
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