Provider Demographics
NPI:1457444887
Name:RPJMR PHARMACY INC
Entity Type:Organization
Organization Name:RPJMR PHARMACY INC
Other - Org Name:GALLO'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNICHARICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-785-9500
Mailing Address - Street 1:310 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3613
Mailing Address - Country:US
Mailing Address - Phone:201-785-9500
Mailing Address - Fax:201-785-9600
Practice Address - Street 1:310 RIDGE RD
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-3613
Practice Address - Country:US
Practice Address - Phone:201-785-9500
Practice Address - Fax:201-785-9600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS006518003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147978OtherPK
NJ0078433Medicaid
NJ0078441Medicaid
5555580001Medicare NSC