Provider Demographics
NPI:1215034145
Name:GEORGE LAWRENCE INC
Entity Type:Organization
Organization Name:GEORGE LAWRENCE INC
Other - Org Name:BALDWIN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-335-5610
Mailing Address - Street 1:128 BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2099
Mailing Address - Country:US
Mailing Address - Phone:973-335-5610
Mailing Address - Fax:973-335-1327
Practice Address - Street 1:128 BALDWIN RD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-2099
Practice Address - Country:US
Practice Address - Phone:973-335-5610
Practice Address - Fax:973-335-1327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS003464003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3125603OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NJ4351002Medicaid
NJ4351002Medicaid