Provider Demographics
NPI:1336240910
Name:RUTGERS NEWARK CAMPUS PHARMACY
Entity type:Organization
Organization Name:RUTGERS NEWARK CAMPUS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARDUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:973-353-5201
Mailing Address - Street 1:249 UNIVERSITY AVE
Mailing Address - Street 2:ROOM 104
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-1808
Mailing Address - Country:US
Mailing Address - Phone:973-353-5201
Mailing Address - Fax:973-353-1390
Practice Address - Street 1:249 UNIVERSITY AVE
Practice Address - Street 2:ROOM 104
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1808
Practice Address - Country:US
Practice Address - Phone:973-353-5201
Practice Address - Fax:973-353-1390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R003068003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3135654OtherNABPH