Provider Demographics
NPI:1659011534
Name:GREENVILLE PHARMACY BUSINESS LLC
Entity Type:Organization
Organization Name:GREENVILLE PHARMACY BUSINESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CICIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOBRIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-433-8002
Mailing Address - Street 1:1850 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-2122
Mailing Address - Country:US
Mailing Address - Phone:201-433-8002
Mailing Address - Fax:
Practice Address - Street 1:1850 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2122
Practice Address - Country:US
Practice Address - Phone:201-433-8002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy