Provider Demographics
NPI:1437297322
Name:LONG VALLEY DRUGS
Entity Type:Organization
Organization Name:LONG VALLEY DRUGS
Other - Org Name:LONG VALLEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIJENDERA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-876-9000
Mailing Address - Street 1:62 E MILL RD STE B2
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3118
Mailing Address - Country:US
Mailing Address - Phone:908-876-9000
Mailing Address - Fax:908-876-5578
Practice Address - Street 1:62 E MILL RD STE B2
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-3118
Practice Address - Country:US
Practice Address - Phone:908-876-9000
Practice Address - Fax:908-876-5578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00685800183500000X, 1835G0303X, 1835N0905X, 1835N1003X, 1835P1200X, 1835P1300X, 1835X0200X, 183700000X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacyGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Multi-Specialty
No1835N0905XPharmacy Service ProvidersPharmacistNuclearGroup - Multi-Specialty
No1835N1003XPharmacy Service ProvidersPharmacistNutrition SupportGroup - Multi-Specialty
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Multi-Specialty
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatricGroup - Multi-Specialty
No1835X0200XPharmacy Service ProvidersPharmacistOncologyGroup - Multi-Specialty
No183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4321502Medicaid
NJ4321502Medicaid