Provider Demographics
NPI:1164594107
Name:WALLINGTON DRUGS INC
Entity Type:Organization
Organization Name:WALLINGTON DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:TARASZKA
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:973-777-2100
Mailing Address - Street 1:130 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-1439
Mailing Address - Country:US
Mailing Address - Phone:973-777-2100
Mailing Address - Fax:973-777-2645
Practice Address - Street 1:130 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057-1439
Practice Address - Country:US
Practice Address - Phone:973-777-2100
Practice Address - Fax:973-777-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4263707OtherUNISYS
NJ3116503OtherNABP
NJ4263707OtherUNISYS