Jea Ava Maria LLC
NPI #1457029563 in Boonton, New Jersey
Provider Information
- NPI Number
- 1457029563
- Entity Type
- Organization
- Organization Name
- Jea Ava Maria LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Sep 2, 2021
- Last Updated
- Sep 2, 2021
Practice Location
- Address
- 203 MAIN ST
- City
- Boonton
- State
- New Jersey
- ZIP Code
- 07005-1749
- Phone
- (973) 334-0519
Authorized Official
- Name
- JOHN GHALY
- Title
- MANAGING MEMBER
- Phone
- (973) 334-0519
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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