Provider Demographics
NPI:1215237722
Name:FAST FILL PHARMACY CORPORATION
Entity type:Organization
Organization Name:FAST FILL PHARMACY CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-408-1100
Mailing Address - Street 1:1900 ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-4627
Mailing Address - Country:US
Mailing Address - Phone:732-408-1100
Mailing Address - Fax:732-408-1105
Practice Address - Street 1:1900 ROUTE 70
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NJ
Practice Address - Zip Code:08759-4627
Practice Address - Country:US
Practice Address - Phone:732-408-1100
Practice Address - Fax:732-408-1105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-31
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00709000333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3197488OtherNCPDP PROVIDER IDENTIFICATION NUMBER