Organization
BARON 11 OF MOONACHIE INC
Active
Other names
BARON II DRUG AND SURGICAL
Organization subpart
No
Provider details
NPI number
Authorized official
RUDOLF TRIVIGNO (PRES)
(201) 641-1110
Entity
Organization
Contact information
Practice address
91 MOONACHIE RD, MOONACHIE, NJ 07074-1016
(201) 641-1110
(201) 659-3113
Mailing address
91 MOONACHIE RD, MOONACHIE, NJ 07074-1016
(201) 641-1110
(201) 659-3113
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00464300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3066908
—
NJ
01
—
3123964
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
4336704
—
NJ
Enumeration date
08/10/2006
Last updated
11/15/2011
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