Organization
CHLONE INC
Active
Other names
Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
DENA FERMAN (THIRD PARTY PLAN COORDINATOR)
(314) 993-6000
Entity
Organization
Contact information
Practice address
458 AMBOY AVE, WOODBRIDGE, NJ 07095-2948
(732) 636-0011
(732) 636-2873
Mailing address
458 AMBOY AVE, WOODBRIDGE, NJ 07095-2948
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
RS006039
NJ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3120451
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8816107
—
NJ
Enumeration date
10/03/2006
Last updated
03/07/2023
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