Organization
PROBENE Q, LLC
Active
Other names
Carepak Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WON KYU SHON (PIC/PRESIDENT)
(201) 916-4899
Entity
Organization
Contact information
Practice address
105 CHALLENGER RD STE 401, RIDGEFIELD PARK, NJ 07660-2101
(201) 225-0057
(201) 225-0067
Mailing address
105 CHALLENGER RD STE 401, RIDGEFIELD PARK, NJ 07660-2101
(201) 225-0057
(201) 225-0067
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00755300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0573035
—
NJ
01
—
2168729
PK
—
Enumeration date
04/07/2017
Last updated
06/23/2022
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