Provider Demographics
NPI:1063293934
Name:ACA PHARMACY LLC
Entity type:Organization
Organization Name:ACA PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:IBRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ATALLA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:732-542-8607
Mailing Address - Street 1:271 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1145
Mailing Address - Country:US
Mailing Address - Phone:732-542-8607
Mailing Address - Fax:
Practice Address - Street 1:271 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OCEANPORT
Practice Address - State:NJ
Practice Address - Zip Code:07757-1145
Practice Address - Country:US
Practice Address - Phone:732-542-8607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy