Provider Demographics
NPI:1770193757
Name:RVL PHARMACY
Entity Type:Organization
Organization Name:RVL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR PHARMACY OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GARETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CERMELE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-377-3307
Mailing Address - Street 1:2500 MAIN ST STE 10
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1473
Mailing Address - Country:US
Mailing Address - Phone:844-785-3937
Mailing Address - Fax:844-567-3937
Practice Address - Street 1:2500 MAIN ST STE 10
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1473
Practice Address - Country:US
Practice Address - Phone:844-785-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy