Provider Demographics
NPI:1114432937
Name:ADLERS PHARMACY LTC
Entity Type:Organization
Organization Name:ADLERS PHARMACY LTC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-685-7264
Mailing Address - Street 1:100 DOBBS LN STE 205
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1436
Mailing Address - Country:US
Mailing Address - Phone:856-685-7264
Mailing Address - Fax:856-520-8464
Practice Address - Street 1:100 DOBBS LN STE 205
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1436
Practice Address - Country:US
Practice Address - Phone:856-685-7264
Practice Address - Fax:856-520-8464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS006136003336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0000400Medicaid