Provider Demographics
NPI:1144218983
Name:KNOWLES PHARMACY INC.
Entity Type:Organization
Organization Name:KNOWLES PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIPITZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:856-825-0721
Mailing Address - Street 1:PO BOX 1005
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-8005
Mailing Address - Country:US
Mailing Address - Phone:856-825-0721
Mailing Address - Fax:856-327-8190
Practice Address - Street 1:600 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-3025
Practice Address - Country:US
Practice Address - Phone:856-825-0721
Practice Address - Fax:856-327-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00188400333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4248309Medicaid
NJ4248309Medicaid