Provider Demographics
NPI:1225618069
Name:KING, AARON WAYNE (RPH)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:WAYNE
Last Name:KING
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 COCELLI DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-2246
Mailing Address - Country:US
Mailing Address - Phone:856-332-2093
Mailing Address - Fax:
Practice Address - Street 1:1230 BLACKWOOD CLEMENTON RD
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-5632
Practice Address - Country:US
Practice Address - Phone:856-627-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01828400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist