Provider Demographics
NPI:1033108659
Name:CAMCOR,INC.
Entity Type:Organization
Organization Name:CAMCOR,INC.
Other - Org Name:VALLEY INTEGRATIVE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:CAMMARATA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-658-4900
Mailing Address - Street 1:75 WASHINGTON VALLEY RD
Mailing Address - Street 2:CN753-432
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921
Mailing Address - Country:US
Mailing Address - Phone:908-658-4900
Mailing Address - Fax:908-658-4132
Practice Address - Street 1:75 WASHINGTON VALLEY RD
Practice Address - Street 2:CN753-432
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921
Practice Address - Country:US
Practice Address - Phone:908-658-4900
Practice Address - Fax:908-658-4132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS004489003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4423305Medicaid
NJ3886660001Medicare NSC