Provider Demographics
NPI:1760473433
Name:D AND L HEALTHCARE INC
Entity Type:Organization
Organization Name:D AND L HEALTHCARE INC
Other - Org Name:FARMINGDALE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DECARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-938-9061
Mailing Address - Street 1:73 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07727-1326
Mailing Address - Country:US
Mailing Address - Phone:732-938-9061
Mailing Address - Fax:732-938-3991
Practice Address - Street 1:73 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NJ
Practice Address - Zip Code:07727-1326
Practice Address - Country:US
Practice Address - Phone:732-938-9061
Practice Address - Fax:732-938-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS003710003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3127405OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NJ6710630001Medicare NSC