Provider Demographics
NPI:1598920449
Name:THE LITTLE DRUG STORE
Entity Type:Organization
Organization Name:THE LITTLE DRUG STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARRIETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARADISO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-256-5400
Mailing Address - Street 1:40 GORDON DR
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 GORDON DR
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2204
Practice Address - Country:US
Practice Address - Phone:973-256-5400
Practice Address - Fax:973-256-3780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0243600001Medicare NSC