Mystic Pharmacy Inc

LBN: Mystic Pharmacy Inc
Mystic Pharmacy Inc is an health care organization with primary practice located at 972 Radio Rd , Little Egg Harbor NJ 08087. The organization recently has only one registered license in Suppliers / Pharmacy, which is considered as the primary health care specialty. Mystic Pharmacy Inc can be contacted via phone (609) 296-0934, or through Ward, John Michael via phone (609) 296-0934.

Contact Information

Primary practice address
972 Radio Rd Little Egg Harbor NJ 08087
Phone: (609) 296-0934
Fax: (609) 296-6250
Website:
Map and Directions
Authorized official contact:
Name: Ward, John Michael RP
Phone: (609) 296-0934

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 28RS00391800 New Jersey

Profile Details

NPI number 1083752216
LBN Legal business name Mystic Pharmacy Inc
DBA Doing business as
Authorized official Ward, John Michael RP
Entity Organization
Organization subpart 1 No
Enumeration date Feb 1st, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083752216 NPPES
New Jersey MEDICAID 4337905

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