Provider Demographics
NPI:1457866881
Name:PHARMACY EMPORIUM LLC
Entity Type:Organization
Organization Name:PHARMACY EMPORIUM LLC
Other - Org Name:PHARMACY EMPORIUM
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MAYANK
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-702-0742
Mailing Address - Street 1:460 COUNTY ROAD 520
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1041
Mailing Address - Country:US
Mailing Address - Phone:732-702-0742
Mailing Address - Fax:732-702-0743
Practice Address - Street 1:460 COUNTY ROAD 520
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1041
Practice Address - Country:US
Practice Address - Phone:732-702-0742
Practice Address - Fax:732-702-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007633003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175229OtherPK