Organization
LIBERTY PHARMACY INC
Active
Other names
Liberty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ASHRAF ASHAMALLA R.PH (PHARMACIST/PRESIDENT)
(201) 993-0978
Entity
Organization
Contact information
Practice address
265 BROADWAY, BAYONNE, NJ 07002
(201) 436-7000
(201) 339-0999
Mailing address
265 BROADWAY, BAYONNE, NJ 07002
(201) 436-7000
(201) 339-0999
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00702500
NJ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124721
PK
—
Enumeration date
04/20/2010
Last updated
05/21/2021
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