Organization
PRINCETON HEALTHCARE SYSTEM A NEW JERSEY NON-PROFIT CORP
Active
Other names
Penn Medicine Princeton Health outpatient pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DEMETRIADES RPH (VICE PRESIDENT)
(609) 853-6113
Entity
Organization
Contact information
Practice address
1 PLAINSBORO RD, PLAINSBORO, NJ 08536-1913
(609) 853-6130
(609) 853-6128
Mailing address
1 PLAINSBORO RD, PLAINSBORO, NJ 08536-1913
(609) 853-6130
(609) 853-6128
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00426800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2055085
PK
—
05
—
6471404
—
NJ
Enumeration date
11/28/2006
Last updated
07/19/2018
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