Organization
ACME MARKETS INC
Active
Other names
ACME PHARMACY #1856
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
19-21 AVE AT PORT IMPERIAL, WEST NEW YORK, NJ 07093-8427
(201) 553-1035
(201) 553-1038
Mailing address
250 E PARKCENTER BLVD, BOISE, ID 83706-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00668700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0521868
—
NJ
Enumeration date
10/11/2017
Last updated
11/07/2018
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