108 Lacey Road LLC
NPI #1831328426 in Whiting, New Jersey
Provider Information
- NPI Number
- 1831328426
- Entity Type
- Organization
- Organization Name
- 108 Lacey Road LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jul 6, 2009
- Last Updated
- Feb 24, 2010
Practice Location
- Address
- 108 LACEY RD
- City
- Whiting
- State
- New Jersey
- ZIP Code
- 08759-1337
- Phone
- (732) 350-7550
Authorized Official
- Name
- SANJAY SHAH
- Title
- OWNER
- Phone
- (732) 350-7550
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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