Provider Demographics
NPI:1568760114
Name:DRUG STORES II LLC
Entity Type:Organization
Organization Name:DRUG STORES II LLC
Other - Org Name:INNOVO SPECIALTY COMPOUNDING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PIUSHBHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:800-307-1778
Mailing Address - Street 1:162 SUMMERHILL RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4929
Mailing Address - Country:US
Mailing Address - Phone:609-308-2832
Mailing Address - Fax:800-307-1779
Practice Address - Street 1:162 SUMMERHILL RD
Practice Address - Street 2:SUITE D
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4929
Practice Address - Country:US
Practice Address - Phone:609-308-2828
Practice Address - Fax:800-307-1779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336M0002X, 3336S0011X
NJ28RS007106003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133962OtherPK