Provider Demographics
NPI:1326365743
Name:PROCITO, SAMUEL F JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:F
Last Name:PROCITO
Suffix:JR
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 1:705 ARROWHEAD CT
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-1337
Mailing Address - Country:US
Mailing Address - Phone:856-227-8158
Mailing Address - Fax:
Practice Address - Street 1:500 WOODBURY GLASSBORO RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-4574
Practice Address - Country:US
Practice Address - Phone:856-582-4300
Practice Address - Fax:856-582-4887
Is Sole Proprietor?:No
Enumeration Date:2010-04-25
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01787200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist