Provider Demographics
NPI:1184488207
Name:TONYS FAMILY PHARMACY
Entity type:Organization
Organization Name:TONYS FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAVAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:732-308-3627
Mailing Address - Street 1:3333 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8503
Mailing Address - Country:US
Mailing Address - Phone:732-308-3627
Mailing Address - Fax:
Practice Address - Street 1:3333 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8503
Practice Address - Country:US
Practice Address - Phone:732-308-3627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy