Organization
MADURA RX LLC
Active
Other names
Madura Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TRUPTI PATEL (PHARMACIST IN CHARGE)
(201) 674-2748
Entity
Organization
Contact information
Practice address
115 N BROADWAY, SOUTH AMBOY, NJ 08879-1648
(732) 721-1732
(732) 553-7252
Mailing address
115 N BROADWAY, SOUTH AMBOY, NJ 08879-1648
(732) 721-1732
(732) 553-7252
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28RS00116700
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0522058
—
NJ
01
—
2155951
PK
—
Enumeration date
12/14/2015
Last updated
09/23/2016
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