Organization
TERRACE APOTHECARY INC
Active
Other names
HAWORTH APOTHECARY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESTLEY V WALLER III PHARMD (PRESIDENT)
(201) 384-7171
Entity
Organization
Contact information
Practice address
169 TERRACE ST, HAWORTH, NJ 07641-1835
(201) 384-7171
(201) 384-4433
Mailing address
169 TERRACE ST, HAWORTH, NJ 07641-1835
(201) 384-7171
(201) 384-4433
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00478500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3134210
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
5406307
—
NJ
Enumeration date
01/16/2006
Last updated
11/18/2016
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