Organization
VIRISAAR PHARMACY INC
Active
Other names
WOOD LANE PHARMACY, WOODLANE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KIRAN TAVVA (VICE-PRESIDENT)
(732) 679-6000
Entity
Organization
Contact information
Practice address
18 THROCKMORTON LN, OLD BRIDGE, NJ 08857-2570
(732) 679-6000
(732) 679-6004
Mailing address
18 THROCKMORTON LN, OLD BRIDGE, NJ 08857-2570
(732) 679-6000
(732) 679-6004
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00640000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060763
—
NJ
01
—
3128407
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/03/2006
Last updated
08/06/2020
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