Provider Demographics
NPI:1184181844
Name:BUNTING PHARMACY LLC
Entity Type:Organization
Organization Name:BUNTING PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNTING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-484-0026
Mailing Address - Street 1:1337 NEW RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1249
Mailing Address - Country:US
Mailing Address - Phone:609-484-0026
Mailing Address - Fax:609-484-0062
Practice Address - Street 1:1337 NEW RD UNIT A
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1249
Practice Address - Country:US
Practice Address - Phone:609-484-0026
Practice Address - Fax:609-484-0062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0183814Medicaid