Provider Demographics
NPI:1285770891
Name:STINES APOTHECARY
Entity type:Organization
Organization Name:STINES APOTHECARY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHABRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-542-8296
Mailing Address - Street 1:1491 ROUTE 38
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2967
Mailing Address - Country:US
Mailing Address - Phone:609-261-9919
Mailing Address - Fax:609-261-9939
Practice Address - Street 1:1491 ROUTE 38
Practice Address - Street 2:
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-2967
Practice Address - Country:US
Practice Address - Phone:609-261-9919
Practice Address - Fax:609-261-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS006660003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2056075OtherPK