Organization
ILUMED LLC
Active
Other names
BARON II DRUG & SURGICAL
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS MEDINA (PHARMACIST-IN-CHARGE)
(201) 641-1110
Entity
Organization
Contact information
Practice address
91 MOONACHIE RD, MOONACHIE, NJ 07074-1016
(201) 641-1110
(201) 641-1113
Mailing address
91 MOONACHIE RD, MOONACHIE, NJ 07074-1016
(201) 641-1110
(201) 641-1113
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00464300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138563
PK
—
Enumeration date
01/22/2013
Last updated
07/15/2013
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