Provider Demographics
NPI:1518609262
Name:ST CYRILL PHARMACY LLC
Entity Type:Organization
Organization Name:ST CYRILL PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:MARYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELNOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-469-9653
Mailing Address - Street 1:327 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3704
Mailing Address - Country:US
Mailing Address - Phone:908-469-9653
Mailing Address - Fax:
Practice Address - Street 1:327 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3704
Practice Address - Country:US
Practice Address - Phone:908-469-9653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy