Provider Demographics
NPI:1023423688
Name:QUICK CHEK CORPORATION
Entity type:Organization
Organization Name:QUICK CHEK CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PHARMACY OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:WUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-534-7190
Mailing Address - Street 1:3 OLD HIGHWAY 28
Mailing Address - Street 2:P.O. BOX 600
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3608
Mailing Address - Country:US
Mailing Address - Phone:908-534-2200
Mailing Address - Fax:908-534-7216
Practice Address - Street 1:3 OLD HIGHWAY 28
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3608
Practice Address - Country:US
Practice Address - Phone:908-534-2200
Practice Address - Fax:908-534-7216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00363800333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy