Medford Leas Pharmacy
LBN: The Estaugh
Medford Leas Pharmacy is an health care organization with primary practice located at 1 Medford Leas , Medford NJ 08055-2254. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Managed Care Organization Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
The Estaugh can be contacted via phone (609) 654-3269, or through Simmons, Frank via phone (609) 654-3391.
Contact Information
Primary practice address
1 Medford Leas
Medford NJ 08055-2254
Phone: (609) 654-3269
Fax: (609) 257-0827
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 28RS00192000 | New Jersey |
| Suppliers / Long Term Care Pharmacy | 3336L0003X | ||
| Suppliers / Managed Care Organization Pharmacy | 3336M0003X |
Profile Details
| NPI number | 1740226836 |
|---|---|
| LBN Legal business name | The Estaugh |
| DBA Doing business as | Medford Leas Pharmacy |
| Authorized official | Simmons, Frank PHARM D |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Jul 20th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740226836 | NPPES |
| Other | 2056046 | PK | |
| MEDICAID | 4303504 | PK |
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