Provider Demographics
NPI:1750933420
Name:BLOOMFIELD CARE PHARMACY CORP
Entity type:Organization
Organization Name:BLOOMFIELD CARE PHARMACY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:FEBYU
Authorized Official - Middle Name:A
Authorized Official - Last Name:GEWARGY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-681-5054
Mailing Address - Street 1:34 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5957
Mailing Address - Country:US
Mailing Address - Phone:201-955-6260
Mailing Address - Fax:201-955-6261
Practice Address - Street 1:34 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5957
Practice Address - Country:US
Practice Address - Phone:201-955-6260
Practice Address - Fax:201-955-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy