Provider Demographics
NPI:1891546834
Name:GUS PHARMACY, LLC
Entity Type:Organization
Organization Name:GUS PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RPIC
Authorized Official - Prefix:
Authorized Official - First Name:KONSTANTINOS
Authorized Official - Middle Name:N
Authorized Official - Last Name:TZAFEROS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:856-346-3535
Mailing Address - Street 1:42 E LAUREL RD STE 1900
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1336
Mailing Address - Country:US
Mailing Address - Phone:856-346-3535
Mailing Address - Fax:856-346-4953
Practice Address - Street 1:42 E LAUREL RD STE 1900
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1336
Practice Address - Country:US
Practice Address - Phone:856-346-3535
Practice Address - Fax:856-346-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy