Provider Demographics
NPI:1306867361
Name:AR EX PHARMACY INC
Entity Type:Organization
Organization Name:AR EX PHARMACY INC
Other - Org Name:AR EX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DATWANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:732-738-1085
Mailing Address - Street 1:370 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-2141
Mailing Address - Country:US
Mailing Address - Phone:732-738-1085
Mailing Address - Fax:732-738-1068
Practice Address - Street 1:370 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-2141
Practice Address - Country:US
Practice Address - Phone:732-738-1085
Practice Address - Fax:732-738-1068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS006520003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0086711Medicaid
2055718OtherPK
NJ0086711Medicaid