Provider Demographics
NPI:1700986437
Name:DS PHARMACY INC
Entity Type:Organization
Organization Name:DS PHARMACY INC
Other - Org Name:DRUGSTORE.COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNFOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-241-5213
Mailing Address - Street 1:407 HERON DR
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1737
Mailing Address - Country:US
Mailing Address - Phone:800-378-4786
Mailing Address - Fax:800-373-6013
Practice Address - Street 1:407 HERON DR
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1737
Practice Address - Country:US
Practice Address - Phone:800-378-4786
Practice Address - Fax:800-373-6013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00587100302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization