Organization
HOMESTEAD PHARMACY
Active
Other names
HOMESTEAD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP DONATO (MANAGER)
(732) 222-5400
Entity
Organization
Contact information
Practice address
601 BROADWAY, LONG BRANCH, NJ 07740-5906
(732) 222-5400
(732) 571-9688
Mailing address
601 BROADWAY, LONG BRANCH, NJ 07740-5906
(732) 222-5400
(732) 571-9688
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00040700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054421
PK
—
05
—
4246900
—
NJ
Enumeration date
09/30/2006
Last updated
02/26/2015
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