Organization
ACME MARKETS INC
Active
Other names
ACME PHARMACY #1058
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY ELIOPULOS (ASSISTANT MANAGER, ENROLLMENTS)
(208) 395-3906
Entity
Organization
Contact information
Practice address
125 FRANKLIN TPKE, MAHWAH, NJ 07430
(201) 529-9760
(201) 529-9767
Mailing address
250 E PARKCENTER BLVD, MAILSTOP SEC2-B, BOISE, ID 83706-3940
(208) 395-3920
(623) 282-3834
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00512000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0517615
—
NJ
01
—
2154247
PK
—
Enumeration date
08/26/2015
Last updated
07/24/2018
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