Provider Demographics
NPI:1215219852
Name:EMERSON PHARMACY COMPOUNDING
Entity Type:Organization
Organization Name:EMERSON PHARMACY COMPOUNDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ALESSANDRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-262-4999
Mailing Address - Street 1:4 EMERSON PLZ W
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1800
Mailing Address - Country:US
Mailing Address - Phone:201-262-4999
Mailing Address - Fax:
Practice Address - Street 1:4 EMERSON PLZ W
Practice Address - Street 2:
Practice Address - City:EMERSON
Practice Address - State:NJ
Practice Address - Zip Code:07630-1800
Practice Address - Country:US
Practice Address - Phone:201-262-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy