Provider Demographics
NPI:1639698517
Name:GSP PHARMACY INC
Entity Type:Organization
Organization Name:GSP PHARMACY INC
Other - Org Name:WASHINGTON SHOP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PINAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-676-0800
Mailing Address - Street 1:90 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-1050
Mailing Address - Country:US
Mailing Address - Phone:973-676-0800
Mailing Address - Fax:973-676-1408
Practice Address - Street 1:90 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1050
Practice Address - Country:US
Practice Address - Phone:973-676-0800
Practice Address - Fax:973-676-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00653400332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies