Provider Demographics
NPI:1003894486
Name:SAFETY DRUGS OF METUCHEN
Entity Type:Organization
Organization Name:SAFETY DRUGS OF METUCHEN
Other - Org Name:WERNIK'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-548-0123
Mailing Address - Street 1:PO BOX 4345
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-4345
Mailing Address - Country:US
Mailing Address - Phone:732-548-0123
Mailing Address - Fax:732-906-9205
Practice Address - Street 1:412 MAIN STREET
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840
Practice Address - Country:US
Practice Address - Phone:732-548-0123
Practice Address - Fax:732-906-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00420600333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4401506Medicaid
NJ4401506Medicaid