Provider Demographics
NPI:1679678999
Name:PINKS DRUG AND SURGICAL COMPANY INC
Entity Type:Organization
Organization Name:PINKS DRUG AND SURGICAL COMPANY INC
Other - Org Name:PINKS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-895-4900
Mailing Address - Street 1:1250 SUSSEX TPKE
Mailing Address - Street 2:
Mailing Address - City:MT FREEDOM
Mailing Address - State:NJ
Mailing Address - Zip Code:07970
Mailing Address - Country:US
Mailing Address - Phone:973-895-4900
Mailing Address - Fax:973-895-3222
Practice Address - Street 1:1250 SUSSEX TPKE
Practice Address - Street 2:
Practice Address - City:MOUNT FREEDOM
Practice Address - State:NJ
Practice Address - Zip Code:07970-7800
Practice Address - Country:US
Practice Address - Phone:973-895-4900
Practice Address - Fax:973-895-3222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS006021003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2057309OtherPK
NJ8668604Medicaid
2057309OtherPK