Provider Demographics
NPI:1609269935
Name:MICHAEL FALCONE, MD, LLC DISPENSARY
Entity Type:Organization
Organization Name:MICHAEL FALCONE, MD, LLC DISPENSARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-567-9233
Mailing Address - Street 1:373 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1135
Mailing Address - Country:US
Mailing Address - Phone:609-567-9233
Mailing Address - Fax:
Practice Address - Street 1:373 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1135
Practice Address - Country:US
Practice Address - Phone:609-567-9233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site